key: cord-0920845-u65s21c7
authors: Au, Sunny Chi Lik; Ko, Callie Ka Li
title: Delayed hospital presentation of acute central retinal artery occlusion during the COVID-19 crisis: the HORA study brief report No. 4
date: 2021-10-03
journal: Indian J Ophthalmol
DOI: 10.4103/ijo.ijo_2005_21
sha: 83f6619a3cf8fcace4334480b46c3841782ab58f
doc_id: 920845
cord_uid: u65s21c7

nan

Volume 69 Issue 10 Under the COVID-19 pandemic, many patients avoided hospital attendance out of fear. [1] There are also observed delays in presentation in patients with acute vascular diseases, including cerebral stroke and myocardial infarction. [2, 3] However, literature search (via PubMed, Medline, EMBASE, Scopus, Cochrane library, and Google Scholar) on whether patients suffering from an acute ocular stroke (i.e., central retinal artery occlusion (CRAO)) behaved similarly did not reveal any previous publication. We retrospectively reviewed our HORA study's data on acute CRAO patients' onset-to-arrival time [4] and analyzed their differences before and during the COVID-19 local outbreak.

HORA study was conducted in a tertiary hyperbaric oxygen therapy (HBOT) center serving 7 million populations as the only territory-wide public and private referral center providing the standard HBOT treatment for every acute CRAO patient. Approved by the local research ethics committee (HKECREC-2020-116), we retrospectively reviewed the onset-to-arrival time (in minutes) of Group 1 (from the start of the HBOT center in November 2018 to the start of the COVID-19 local outbreak in February 2020) and Group 2 (during the four local waves of COVID-19 outbreak, ending on March 2021) patients. Normal distribution was tested by the Shapiro-Wilk test, and data were then compared using SPSS version 27. Table 1 . Group 1's onset-to-arrival time was 124.1+/−102.9 minutes, which was not normally distributed. In contrast, Group 2's onset-to-arrival time was in a normal distribution and was 236.2+/−108.7 minutes. Nonparametric test (Mann-Whitney U) was used to compare the data, which yielded Z = −2.96 and P = 0.003.

Acute CRAO patients presented to the hospital 112.1 minutes later during the COVID-19 outbreak, which is a critical timeframe for irreversible photoreceptor changes. Our study is the first to report a delay in hospital presentation of acute CRAO during the COVID-19 crisis. Given the low incidence of CRAO, our limited sample size of 40 is comparable to most published CRAO HBOT studies. [5] Financial support and sponsorship Nil.

There are no conflicts of interest.

A surge in eye clinic nonattendance under 2019 novel coronavirus outbreak

Delays in stroke onset to hospital arrival time during COVID-19

Delays in presentation in patients with acute myocardial infarction during the COVID-19 pandemic

Prevalence of SARS-CoV-2 among central retinal artery occlusion patients: A case series-HORA study report No. 3

Oxygen therapy in patients with retinal artery occlusion: A meta-analysis