tetano
Editor, Senior Moderator
Immun Inflamm Dis
. 2026 May;14(5):e70455.
doi: 10.1002/iid3.70455.
Impact of Early COVID-19 Antiviral Therapy on the Incidence of Uveitis: A Retrospective Cohort Study Using the TriNetX Database
Hou-Ting Kuo[SUP] 1 [/SUP], Alan Y Hsu[SUP] 1 [/SUP], De-Yi Liu[SUP] 2 [/SUP], Bing-Qi Wu[SUP] 2 [/SUP], James Cheng-Chung Wei[SUP] 3 4 5 [/SUP], Ning-Yi Hsia[SUP] 1 6 7 [/SUP], Yi-Ching Shao[SUP] 1 6 8 [/SUP], Chun-Ting Lai[SUP] 1 6 7 [/SUP], Chun-Chi Chiang[SUP] 1 6 7 [/SUP], Chun-Ju Lin[SUP] 1 6 7 [/SUP], Huan-Sheng Chen[SUP] 9 [/SUP], Yu-Hsun Wang[SUP] 10 [/SUP], Hsin Tseng[SUP] 1 [/SUP], Ho-Che Hsu[SUP] 1 [/SUP], Yi-Yu Tsai[SUP] 1 6 7 [/SUP]
Affiliations
Objective: To assess whether antivirals are associated with a reduced incidence of uveitis following COVID-19.
Methods: We conducted a multi-institutional, population-based retrospective cohort study of adults (≥ 18 years) diagnosed with COVID-19 between 2022 and 2024. Patients who received antiviral agents (Paxlovid, Molnupiravir, or Remdesivir) within 5 days of diagnosis were matched 1:1 with untreated controls using propensity score matching. Patients with pre-existing uveitis, early-onset uveitis within 5 days of the index date, or underlying systemic inflammatory or infectious diseases were excluded. The primary outcome was new-onset uveitis, with hazard ratios (HRs) calculated across follow-up intervals.
Results: After matching, 438,455 patients were included in both the antiviral and non-antiviral groups. Antiviral therapy was associated with a significantly lower risk of uveitis at 3 months (HR = 0.62, 95% CI: 0.45-0.87), 6 months (HR = 0.68, 95% CI: 0.54-0.87), 1 year (HR = 0.76, 95% CI: 0.64-0.91), 3 years (HR = 0.80, 95% CI: 0.70-0.92), and all duration (HR = 0.81, 95% CI: 0.71-0.93). Subgroup analysis revealed consistent benefit across all age groups, with females experiencing greater protection than males. Significant reductions in uveitis risk were observed among patients with diabetes (HR = 0.68, 95% CI: 0.52-0.89), hyperlipidemia (HR = 0.78, 95% CI: 0.65-0.95), and heart failure (HR = 0.52, 95% CI: 0.30-0.90). Among the antivirals, Paxlovid was associated with a significant risk reduction (HR = 0.83, 95% CI: 0.71-0.96), whereas Molnupiravir and Remdesivir showed no statistically significant effect. CEV classification did not show significant improvement. Besides, the risk reduction was evident regardless of prior COVID-19 vaccination status.
Conclusions: Early antiviral treatment for COVID-19 such as Paxlovid, is associated with a reduced risk of uveitis. These findings suggest that, in addition to mitigating systemic disease progression, antiviral therapy may confer ocular protective effects, which could be especially meaningful for high-risk populations.
Keywords: COVID‐19; antiviral; uveitis.
. 2026 May;14(5):e70455.
doi: 10.1002/iid3.70455.
Impact of Early COVID-19 Antiviral Therapy on the Incidence of Uveitis: A Retrospective Cohort Study Using the TriNetX Database
Hou-Ting Kuo[SUP] 1 [/SUP], Alan Y Hsu[SUP] 1 [/SUP], De-Yi Liu[SUP] 2 [/SUP], Bing-Qi Wu[SUP] 2 [/SUP], James Cheng-Chung Wei[SUP] 3 4 5 [/SUP], Ning-Yi Hsia[SUP] 1 6 7 [/SUP], Yi-Ching Shao[SUP] 1 6 8 [/SUP], Chun-Ting Lai[SUP] 1 6 7 [/SUP], Chun-Chi Chiang[SUP] 1 6 7 [/SUP], Chun-Ju Lin[SUP] 1 6 7 [/SUP], Huan-Sheng Chen[SUP] 9 [/SUP], Yu-Hsun Wang[SUP] 10 [/SUP], Hsin Tseng[SUP] 1 [/SUP], Ho-Che Hsu[SUP] 1 [/SUP], Yi-Yu Tsai[SUP] 1 6 7 [/SUP]
Affiliations
- PMID: 42093120
- PMCID: PMC13149768
- DOI: 10.1002/iid3.70455
Objective: To assess whether antivirals are associated with a reduced incidence of uveitis following COVID-19.
Methods: We conducted a multi-institutional, population-based retrospective cohort study of adults (≥ 18 years) diagnosed with COVID-19 between 2022 and 2024. Patients who received antiviral agents (Paxlovid, Molnupiravir, or Remdesivir) within 5 days of diagnosis were matched 1:1 with untreated controls using propensity score matching. Patients with pre-existing uveitis, early-onset uveitis within 5 days of the index date, or underlying systemic inflammatory or infectious diseases were excluded. The primary outcome was new-onset uveitis, with hazard ratios (HRs) calculated across follow-up intervals.
Results: After matching, 438,455 patients were included in both the antiviral and non-antiviral groups. Antiviral therapy was associated with a significantly lower risk of uveitis at 3 months (HR = 0.62, 95% CI: 0.45-0.87), 6 months (HR = 0.68, 95% CI: 0.54-0.87), 1 year (HR = 0.76, 95% CI: 0.64-0.91), 3 years (HR = 0.80, 95% CI: 0.70-0.92), and all duration (HR = 0.81, 95% CI: 0.71-0.93). Subgroup analysis revealed consistent benefit across all age groups, with females experiencing greater protection than males. Significant reductions in uveitis risk were observed among patients with diabetes (HR = 0.68, 95% CI: 0.52-0.89), hyperlipidemia (HR = 0.78, 95% CI: 0.65-0.95), and heart failure (HR = 0.52, 95% CI: 0.30-0.90). Among the antivirals, Paxlovid was associated with a significant risk reduction (HR = 0.83, 95% CI: 0.71-0.96), whereas Molnupiravir and Remdesivir showed no statistically significant effect. CEV classification did not show significant improvement. Besides, the risk reduction was evident regardless of prior COVID-19 vaccination status.
Conclusions: Early antiviral treatment for COVID-19 such as Paxlovid, is associated with a reduced risk of uveitis. These findings suggest that, in addition to mitigating systemic disease progression, antiviral therapy may confer ocular protective effects, which could be especially meaningful for high-risk populations.
Keywords: COVID‐19; antiviral; uveitis.