Endogenous Endophthalmitis Associated With COVID-19: A Systematic Review on Its Incidence, Risk Factors, Causative Organisms, and Prognosis

Endogenous endophthalmitis (EE) is a rare but severe intraocular infection resulting from hematogenous dissemination of microorganisms. During the COVID-19 pandemic, there has been a notable increase in EE cases. This literature review aims to evaluate studies focusing on EE associated with COVID-19 to elucidate its pathogenesis and optimize patient management strategies. A thorough search was conducted across PubMed, ScienceDirect, and Google Scholar for relevant research. The surge in EE cases during the COVID-19 pandemic is likely linked to alterations in immune status and systemic comorbidities exacerbated by the virus and its treatments. Notably, Candida albicans and Aspergillus species emerged as the predominant fungal pathogens in these cases. The findings suggest that the increased incidence of EE is associated with immune dysregulation and increased vulnerability of COVID-19 patients, particularly those with severe diseases or undergoing immunosuppressive treatments. Early diagnosis with timely and effective treatment is crucial for improving patient outcomes. Regular ophthalmic evaluations for hospitalized COVID-19 patients are strongly advised to detect and address ocular complications early.