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Multicenter Study
. 2024 Dec 24;24(1):546.
doi: 10.1186/s12886-024-03769-z.

Daily activities change is linked to acute angle closure occurrence in COVID-19 co-infected patients

Xiaojie Wang  1 , Aijun Tian  2 , Shaodan Zhang  1 , Bo Qu  3 , Lijun Zhao  4 , Xiaojing Pan  5 , Peng Lu  6 , Xinqi Chang  7 , Lu Yang  8 , Shaoping Ha  9 , Jibing Wang  10 , Jiangang Yang  11 , Xiaohui Wang  12 , Peng Yao  13 , Yuxia Yang  14 , Wenzong Zhou  15 , Zhaoyi Wang  16 , Juntao Zhang  17 , Chuanqi Lin  18 , Junhua Li  1 , Yanhua Jiang  19 , Zhongxia Cheng  20 , Zhixiang Ding  21 , Siying Xiong  22 , Cong Ye  1 , Houyu Zhao  23 , Nathan Congdon  24 , Yuanbo Liang  25
Affiliations
Multicenter Study

Daily activities change is linked to acute angle closure occurrence in COVID-19 co-infected patients

Xiaojie Wang et al. BMC Ophthalmol. .

Abstract

Objectives: To analyze the influence of daily activity-related factors associated with COVID-19 infection on the occurrence of acute angle closure (AAC).

Methods: A multicenter hospital-based study was conducted at 23 ophthalmic centers in 17 provincial-level regions across China to recruit patients with confirmed AAC during the post-lockdown time of COVID-19 (P-TOC) from Dec 7, 2022, to Jan 17, 2023, and three lockdown time of COVID-19 (TOC) periods, which included the TOC-2022 (Sep 7, 2022 - Dec 6, 2022), TOC-2021(Sep 7, 2021 - Jan 6, 2022) and TOC-2020 (Sep 7, 2020 - Jan 6, 2021). Patient information, including demographic, a questionnaire on daily activity changes during the AAC period, COVID-19 history, and eye examination results, was collected.

Results: The study involved 3216 AAC cases, with 76.2% being female and 78.9% aged over 60 years. AAC occurrences during P-TOC was nearly tripled compared to the corresponding months in TOC-2021 and TOC-2020. Patients with AAC comorbidity and COVID-19 had significantly higher water intake (37.3% vs. 2.2%, p < 0.001) and poorer sleep quality (49.16% vs. 4.07%, p < 0.001) than those without COVID-19 comorbidity, while about 58.4% of these patients received antipyretic analgesic drugs for symptom management. The COVID-19 group showed higher intraocular pressure as well as worse uncorrected distance visual acuity, when compared to non-COVID-19 patients.

Conclusions: The relationship between AAC occurrence and daily activity factors associated with COVID-19 suggests that patient management should account for changes in daily activities.

Keywords: Acute angle closure; COVID-19; Daily activity.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study followed the tenets of the Declaration of Helsinki and was approved by the Ethics committee of the Eye Hospital of Wenzhou Medical University Institutional Review Board (2023 Science Ethic No.13). Patient informed consent was waived for this retrospective non-interventional study in accordance with Chinese regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study timeline. The study conducted over four time periods: TOC-2020 (September 7, 2020 to January 6, 2021), TOC-2021 (September 7, 2021 to January 6, 2022), TOC-2022 (September 7, 2022 to December 6, 2022), and P-TOC [(includes P-TOC-1 (December 7, 2022 to January 6, 2023) and P-TOC-2 (January 7, 2023 to January 17, 2023)]. The lockdown period was scheduled from 2020 until December 6, 2022 (Lockdown time), with the lifting of restrictions commencing on December 7, 2022 (Post-lockdown time)
Fig. 2
Fig. 2
Changes in the number of new-onset acute angle closure (AAC) admissions during the study period. (a) depicts the trends in blue, representing the observed number of new-onset AAC cases, while the red trends represent AAC patients with comorbidity with COVID-19. (b) displays monthly cases of new AAC admissions categorized into three time periods (2020–2021, 2021–2022, and 2022–2023). (c) presents both actual and predictive values obtained from an exponential smoothing model for assessing the number of new-onset AAC cases. Further details can be found in the main text. COVID-19 = Coronavirus Disease 2019
Fig. 3
Fig. 3
The proportion of new-onset acute angle closure patients at different time points from symptom onset to presentation between the COVID-19 group and non-COVID-19 group following the relaxation of zero-COVID-19 policy. The bias line represents the COVID-19 group, and the grey line represents the Non-COVID-19 group. AAC = acute angle closure; COVID-19 = Coronavirus Disease 2019
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