Abstract

The aim of this study was to investigate the occurrence of Dry Eye Syndrome (DES) in children under 18 years old before and during the COVID-19 pandemic using nationwide population-based cohort analysis. This study utilized the database provided by the Korea Disease Control and prevention Agency (KDCA) and the National Health Insurance Service (NHIS). We used claims-based data for patients diagnosed with coronavirus disease-2019 (COVID-19) between October 8, 2020, and December 31, 2021, and those without a diagnosis of COVID-19. DES cases were defined as having at least one diagnosis of H0411 or H1621 based on the International Classification of Diseases, 10th revision (ICD-10) codes. The primary outcome was the evaluation of the hazard ratio (HR) for DES between the COVID-19 season and the non-COVID-19 season. A total of 198,486 individuals from the COVID-19 season cohort and 211,828 individuals from the non-COVID-19 season cohort were included in the study. There were no differences in characteristics between the COVID-19 season cohort and the non-COVID-19 season cohort (all SMDs < 0.1). The cumulative incidence of DES during the COVID-19 season was significantly higher than that during the non-COVID-19 season. The COVID-19 season DES incidence rate was 6419.64 per 100,000 person-years (P-Y) and non-COVID-19 season DES incidence rate was 5804.88. In addition, 13-18-year-olds, females, those in Metropolitan areas, and diabetes mellitus had a higher risk of DES. The prevalence of diagnosed DES in children increased during the COVID-19 pandemic compared to previous years. Children aged 13-18, females, and those living in metropolitan areas had a higher risk of DES. Further studies are needed to directly analyze the potential factors associated with the increased prevalence of DES.

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