Ophthalmic pathology treated during Covid-19 at the Ophthalmology Clinic of “Sf. Spiridon” County Clinical Emergency Hospital in Iaşi, Romania

Abstract

Within the current epidemiological context and due to the increased risk of infectivity, this article focuses on the practical activity of "Sf. Spiridon" Ophthalmology Clinic in Iasi, during the emergency period (March 16th -May 16th, 2020), the evaluated ocular pathology and the approached strategy from the point of view of medical and surgical vision. Material and methods: As an Emergency Hospital and Tertiary Center of Moldova, Romania "Sf. Spiridon" Hospital in Iasi was the only hospital in the region that dealt with all the urgent ophthalmological pathology during COVID-19. The clinic worked due to the established protocol, the patient's circuit was changed, with the buffer zone for the suspicious COVID-19 patient, where the patient was hospitalized until the negative PCR result. All patients having a negative PCR test benefited from both medical and / or surgical treatment depending on the type of ocular pathology. Results: 619 patients were examined in the emergency room, of which 61 patients were hospitalized in Clinic I Ophthalmology, "Sf. Spiridon" Hospital in Iasi, between March 16 and May 16, 2020. Most patients (59%) came from the neighboring counties (Suceava, Vaslui, Piatra Neamt, Bacau) the rest being from Iasi (41%). The age varied from 2 to 87 years, the average age being 51.72 +/- 22.16. Most frequently, patients were hospitalized with retinal detachment (29.5%), trauma (24.6%) and corneal sclerosis (13.1%), most cases being surgical. The average length of stay was 6.3 days. The average time of surgery stages was 45 minutes. The condition at discharge was in 60% of cases improved and 30% cured. All patients tested negative for COVID-19 PCR. Visual acuity and IOP showed slightly higher / lower changes at discharge than at the time of admission. Depending on the diagnosis, the average stay for the patients with retinal detachment was about 4 days, while for patients with glaucoma (13 days) or ulcer corneal (12 days), the long-term hospitalization exceeded 12 days. The multivariate analysis showed that about 10% of the number of days spent in hospital (dependent variable) can be explained by the diagnosis of hospitalization and the type of intervention. Correlated with the status of discharge, the number of days spent in hospital did not differ significantly. Conclusions: Most of the ophthalmological activity during the pandemic was surgical, due to the large number of trauma cases from neighboring counties, being the only non-COVID-19 hospital in the North-eastern region of Romania. Complying with the protocol suggested by the American Academy of Ophthalmology for protection in the case of ophthalmic surgery allows standard eye care and safe surgery to maintain a sustainable application.