key: cord-0997021-nsuvhpu6
authors: Takagi, Hisato
title: Eyeglasses in the wonderland of COVID‐19
date: 2021-02-12
journal: J Med Virol
DOI: 10.1002/jmv.26845
sha: 91e13b8250024826f404406adbdfb05b7490ce20
doc_id: 997021
cord_uid: nsuvhpu6

A recent cohort study1 at Suizhou in China identified that the proportion of subjects who wore eyeglasses was lower in hospitalized patients with coronavirus disease 2019 (COVID-19) than in the general population. This article is protected by copyright. All rights reserved.

The myopia prevalence was significantly and negatively associated with the COVID-19 incidence (coefficient [slope of the meta-regression line], Myopia prevalence, however, was not correlated to fatality (coefficient, -0.073 of logarithmic percent per 1% increase in myopia prevalence; 95% CI, -0.176 to 0.031; p = .169; Figure 2 , lower panel). In multivariable regression, myopia prevalence was still significantly and negatively associated with the COVID-19 incidence and the test-positive rate, whereas it was not correlated to mortality (Table 2 ). Similar analyses were performed for hyperopia and cataract. The hyperopia prevalence was associated with none of the COVID-19 incidence (p = .065), testpositive rate (p = .543), mortality (p = .055), and fatality (p = .357). The cataract prevalence was also correlated to none of the COVID-19 incidence (p = .819), test-positive rate (p = .445), mortality (p = .712), and fatality (p = .672).

The present study indicated the significant, independent, and negative association of the myopia prevalence with the COVID-19 cumulative incidence and the test-positive rate (neither the mortality nor the fatality) in US states, which suggests a probably negative correlation of wearing eyeglasses to COVID-19 infection because eyeglasses are the primary choice for optical correction in most myopia patients (https://www.aoa.org/healthy-eyes/eye-and-visionconditions/myopia?sso=y). Wider view fields and clearer vision, however, may be offered by contact lenses than eyeglasses for some subjects, and laser procedures (e.g., laser in situ keratomileusis or photorefractive keratectomy) are also potential options for adult myopia (https://www.aoa.org/healthy-eyes/eye-and-vision-conditio ns/myopia?sso=y). According to the "Vision Council of America (https://www.thevisioncouncil.org)," 75% of adults need vision correction, and 64% and 11% of them wear eyeglasses and contact lenses, respectively. In accordance to "Jobson Optical Research (https://jobsonresearch.com)," 61% of the population in the United States use some sort of vision correction, and 61% of them need eyewear due to myopia. Due to the community-level (not patientlevel) study design, the present findings simply denote that COVID-19 infection was less frequent in states where myopia patients (who probably wore eyeglasses) were more present, and never directly import that a myopia patient is at low risk of wearing eyeglasses with less frequent COVID-19 infection. Similar to their study, which compared the proportion of COVID-19 patients who wore "eyeglasses" (all of them suffered "myopia") with that of "myopia" patients (not subjects who wore "eyeglasses") in the general population, the present study investigated the proportion of "myopia" patients (not subjects who wore "eyeglasses") because of unavailable data on wearing "eyeglasses." The sample size, however, was far greater in the present study (approximately 6.8-million

States) than in the study by Zeng et al. 1 (merely 276 COVID-19 patients and 16 myopia ones at a city in China).

Angiotensin-converting enzyme 2 (which is known as a SARS-CoV-2 receptor) has been identified in the human retinal as well as non-retinal ocular structure. 2 One-third of COVID-19 patients suffered conjunctivitis (including conjunctival hyperemia, chemosis, epiphora, or increased secretion) which is more frequent in patients with more severe COVID-19. 3

Eyeglasses may evade hand-to-eye transfer of the virus by means of restraint and dissuasion of feeling eyes. 1 The "COVID-19 advice for the public" by the World Health Organization (WHO) (https://www.who.int/ emergencies/diseases/novel-coronavirus-2019/advice-for-public) also recommends to avoid touching eyes.

Several issues should be noted as limitations of the present study. First, although the myopia prevalence was provided in merely

≥40-year subjects, the COVID-19 cumulative incidence was reported in all-age subjects. Second, the myopia prevalence is 1. In conclusion, on the basis of data from US states, myopia prevalence was independently and negatively associated with the COVID-19 cumulative incidence and the test-positive rate (neither the mortality nor the fatality), which suggests that wearing eyeglasses may be negatively correlated to COVID-19 infection but doesn't import that a myopia patient is at low risk of COVID-19 infection.

Hisato Takagi Email: kfgth973@ybb.ne.jp Abbreviations: LLCI, lower limit of 95% confidence interval; ULCI, upper limit of 95% confidence interval.*Statistically significant.

Hisato Takagi http://orcid.org/0000-0002-5594-8072

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