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  • COVID-19 Outcomes in Patients With AMD

    By Lynda Seminara
    Selected by Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, July 2022

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    COVID-19 and age-related macular degeneration (AMD) each are linked to inflammaging, a term for human aging characterized by chronic low-grade systemic inflammation. More­over, COVID-19 and AMD share an underlying mechanism—dysregulation of complement cascades—which may explain the observation that patients with AMD have a higher risk for severe COVID and poor outcomes. To further explore the relationship between AMD and SARS-CoV-2 susceptibility and outcomes, Yang et al. stratified AMD subtypes and used propensity-score matching to reduce confounder bias in a large study of patients with SARS-CoV-2. They found that the presence of exudative AMD increases the likelihood of testing positive for COVID and is a harbinger of poor outcome after infection.

    For this two-sample nationwide cohort study in South Korea, the authors gathered data from COVID-19 registries and a national claims-related database on patients ≥40 years of age who had a SARS-CoV-2 test during the first 4½ months of 2020. Self-referrals were excluded. Outcome measures were results of polymerase chain reaction testing for SARS-CoV-2 and related clinical outcomes. Confounders of interest included age, sex, and history of predesignated diseases (such as hypertension, diabetes, chronic kidney disease, and lung disease). Outcomes considered “severe” were ICU admis­sion, mechanical ventilation, oxygen supplementation, and/or death.

    The unmatched cohort comprised 135,435 patients who underwent SARS- CoV-2 testing. Of these, 4,531 (3.3%) had a positive COVID result, and 5,493 (4.1%) had AMD (mean age, 72.5 years). Patients with exudative AMD were older, more likely male, and more often had a history of comorbidity (all p < .001). Matched groups had no significant difference in baseline char­acteristics.

    Of those who tested positive for COVID, 150 also had AMD. After propensity score matching, exudative AMD was associated with an increased likelihood of susceptibility to SARS-CoV-2 infection (adjusted odds ratio [OR], 1.50; 95% confidence interval [CI], 1.03-2.25). In addition, exudative AMD was associated with a greater risk of severe COVID outcomes (OR, 2.26; 95% CI, 1.02-5.26).

    To validate findings of this study, the authors urge research in large national, international, and multiethnic popula­tions.

    The original article can be found here.