Corneal confocal microscopy identifies corneal nerve fibre loss and increased dendritic cells in patients with long COVID.

BACKGROUND/AIMS: Long COVID is characterised by a range of potentially debilitating symptoms which develop in at least 10% of people who have recovered from acute SARS-CoV-2 infection. This study has quantified corneal sub-basal nerve plexus morphology and dendritic cell (DC) density in patients with and without long COVID. METHODS: Forty subjects who had recovered from COVID-19 and 30 control participants were included in this cross-sectional comparative study undertaken at a university hospital. All patients underwent assessment with the National Institute for Health and Care Excellence (NICE) long COVID, Douleur Neuropathique 4 (DN4) and Fibromyalgia questionnaires, and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), corneal nerve fibre length (CNFL), and total, mature and immature DC density. RESULTS: The mean time after the diagnosis of COVID-19 was 3.7±1.5 months. Patients with neurological symptoms 4 weeks after acute COVID-19 had a lower CNFD (p=0.032), CNBD (p=0.020), and CNFL (p=0.012), and increased DC density (p=0.046) compared with controls, while patients without neurological symptoms had comparable corneal nerve parameters, but increased DC density (p=0.003). There were significant correlations between the total score on the NICE long COVID questionnaire at 4 and 12 weeks with CNFD (ρ=-0.436; p=0.005, ρ=-0.387; p=0.038, respectively) and CNFL (ρ=-0.404; p=0.010, ρ=-0.412; p=0.026, respectively). CONCLUSION: Corneal confocal microscopy identifies corneal small nerve fibre loss and increased DCs in patients with long COVID, especially those with neurological symptoms. CCM could be used to objectively identify patients with long COVID.

Abnormal quantitative pupillary light responses following COVID-19.

PURPOSE: To characterize alterations in pupillary light reflex responses in subjects following coronavirus disease 2019 (COVID-19), especially those with long-COVID. METHODS: Thirty-five subjects with previous COVID-19 and 30 healthy control participants were enrolled in this cross-sectional comparative study. An infrared dynamic pupillometry system (MonPack One; Metrovision, France) was used to quantify pupillary light responses. The National Institute for Health and Care Excellence (NICE) long-COVID questionnaire was used to identify persisting symptoms at least 4 weeks after acute COVID-19. RESULTS: The median time after the diagnosis of acute COVID-19 was 4.0 (2.0-5.0) months. There was an increase in the latency of pupil contraction (P = 0.001) and a reduction in the duration of pupil contraction (P = 0.039) in post-COVID-19 subjects compared to healthy controls. No significant differences were observed in the initial pupil diameter, amplitude and velocity of pupil contraction or latency, velocity and duration of pupil dilation. Long-COVID was present in 25/35 (71%) subjects and their duration of pupil contraction was reduced compared to subjects without long-COVID (P = 0.009). The NICE long-COVID questionnaire total score (ρ = - 0.507; P = 0.002) and neurological score (ρ = - 0.412; P = 0.014) correlated with the duration of pupil contraction and the total score correlated with the latency of dilation (ρ = - 0.352; P = 0.038). CONCLUSION: Dynamic pupillometry reveals significant alterations in contractile pupillary light responses, indicative of parasympathetic dysfunction after COVID-19.

Epidemiological characteristics of patients with Covid-19 suspicion applying to a university hospital: The first eighty days in a pandemic

Aim: The first COVID-19 case in Turkey was detected on March 11, 2020 during the COVID-19 pandemic process. Epidemiological studies are needed to be prepared for other outbreaks and to be effective in the disease management process. Based on this reason, in this study it was aimed to determine the epidemiological characteristics of Covid 19 possible and definite cases who applied to the university hospital during the pandemic process. Materials and Methods: This retrospective epidemiological study was carried out by analyzing the data of Covid 19 possible and definite cases, who applied to the university hospital operating as a pandemic hospital between 11 March / 01 June 2020. The data were summarized with descriptive statistics, tables and graphs. Results: Of the 1,383 patients, who applied with the suspicion of COVID-19, 55.5% were men and 84.5% were adults. The median age of children is 4.0 (1.5-10) years old;adults were 52.0 (36.0-67.0) years old. The median time between the outset of complaints and the date of admission to the hospital was 2 (1-3) days. 87.4% of adults and 87.9% of children had symptoms that supported COVID-19 infection. Among cases 7.8% were health care workers. The median age of the fatal cases was 71 (64-82) years old, 79.5% were male, 77.7% were retired. The most common comorbide diseases in these cases were hypertension (28.2%) and malignancy (28.2%). The case fatality rate was found as 2.8% in all patients and 48.4% in patients hospitalized in the intensive care unit. Conclusions: As a result, Covid-19 affects all age groups. Hypertension and malignancy were the most common additional diseases in fatal cases. The risk of illness is higher in healthcare workers who have direct contact with the patients. According to our observations, preventive measures, rapid diagnosis and supportive treatment are valuable. [ABSTRACT FROM AUTHOR] Copyright of Annals of Medical of Research is the property of Annals of Medical Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)