Evaluation of an Association Between COVID-19 Infection and Retinal Hemorrhage in Children.
Publication/Presentation Date
8-22-2025
Abstract
OBJECTIVE: To evaluate the association of retinal hemorrhage with COVID-19 infection in children.
DESIGN: Retrospective cohort study.
PARTICIPANTS: Inpatients and outpatients at Children's Hospital of Philadelphia, ages 1 month to 18 years, who had a dilated fundus examination by an ophthalmologist within one month of a COVID-19 test between January 2020 and October 2023.
METHODS: Medical records were reviewed for the results of COVID-19 testing and retinal findings. Primary outcome was the association between COVID-19 and retinal hemorrhage assessed across 4 time periods: retinal exam within 7 days, 14 days, 21 days, or 28 days of COVID-19 testing. Generalized estimating equations were used to determine statistical significance and control for age and multiple COVID-19 tests.
MAIN OUTCOME MEASURES: Association between COVID-19 infection and presence of retinal hemorrhage.
RESULTS: Among 6,952 children (mean age 6.1 years) studied, 3,496, 4,758, 5,887, and 6,952 children underwent fundus exam within 1, 2, 3, and 4 weeks of a COVID test, respectively. There were no associations between COVID-19 infection and the presence of retinal hemorrhage in any of the time periods: 7 days (OR: 0.80; 95% CI: 0.20-3.32; P=0.76), 14 days (OR: 0.75; 95% CI: 0.24-2.00; P=0.63), 21 days (OR: 0.79; 95% CI: 0.29-2.15; P=0.64), or 28 days (OR: 0.63; 95% CI: 0.23-1.72; P=0.37). All four COVID-19 positive children with retinal hemorrhage had alternative plausible causes with hemorrhage patterns consistent with those other causes.
CONCLUSIONS: COVID-19 infection is not associated with retinal hemorrhage in children. COVID-19 should not be considered as a potential cause of retinal hemorrhage in children, and this unsupported theory should not be accepted clinically or in legal proceedings.
ISSN
1549-4713
Published In/Presented At
Zhao, A. T., Laub, N., He, J., Yu, Y., Spiller, A., & Binenbaum, G. (2025). Evaluation of an Association Between COVID-19 Infection and Retinal Hemorrhage in Children. Ophthalmology, S0161-6420(25)00522-6. Advance online publication. https://doi.org/10.1016/j.ophtha.2025.08.012
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
40850347
Department(s)
Department of Pediatrics
Document Type
Article