Long COVID and the development of new-onset uveitis: a large database study

To determine the impact of long COVID diagnosis on the risk of developing uveitis among individuals vaccinated and not vaccinated against COVID.

We conducted a population-based retrospective cohort study using an aggregate healthcare database, TriNetX, which includes data from over 127 million patients across 95 international healthcare organizations. Four cohorts were compared: (1) Unvaccinated, Long COVID; (2) Unvaccinated, No Long COVID; (3) Vaccinated, Long COVID; and (4) Vaccinated, No Long COVID. Patients with any history of uveitis prior to initial COVID diagnosis were excluded. The primary outcome was the risk of new-onset uveitis at 1 and 2 years following the diagnosis of long COVID.

Unvaccinated, long COVID patients demonstrated an increased risk of developing new-onset uveitis compared to unvaccinated, no long COVID controls at 1 year (aHR: 2.01, 95% CI: 1.19-3.38) and 2 years (aHR: 1.60, 95% CI: 1.08-2.37). The highest risk was seen for anterior uveitis at 1 year (aHR: 1.96, 95% CI: 1.13-3.41) and 2 years (aHR: 1.59, 95% CI: 1.06-2.40). Other uveitis subtypes did not show an increased risk in this cohort. Among vaccinated individuals, there was not increased risk in those with long COVID compared to those without at 1 year (aHR: 0.95, 95% CI: 0.58-1.55) and 2 years (aHR: 0.97, 95% CI: 0.65-1.46).

Unvaccinated individuals with long COVID have an increased risk of developing new uveitis, particularly anterior uveitis. Vaccinated individuals with long COVID did not have an increased risk of developing uveitis compared to vaccinated non-long COVID individuals.