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Am J Ophthalmol ; 227: 182-190, 2021 07.
Article in English | MEDLINE | ID: covidwho-1157088


PURPOSE: This study investigated changes in retinal vessel density in macular and papillary regions in post-SARS-CoV-2 pneumonia patients by means of optical coherence tomography angiography (OCTA). DESIGN: Prospective, observational, cohort study. METHODS: Forty eyes of 40 patients (mean age: 49.7 ± 12.6 years old) post-SARS-CoV-2 infection and 40 healthy subjects were enrolled in this study. COVID-19 patients had to be fully recovered from COVID-19 pneumonia and were evaluated 6 months after COVID-19 infection. The primary outcome resulted from OCTA studies of the following vascular structures: vessel density (VD) in the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillaries (RPC) compared to those of controls. Structural spectral domain (SD)-OCT parameters were also evaluated: ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). RESULTS: The patients showed a significant reduction in VD of the SCP in whole images and in the DCP in all sectors compared to those in healthy subjects (P <.05). COVID-19 patients featured a reduced VD of the RPC compared to that in controls (P <.001). No differences were found in the GCC, whereas the RNFL was reduced in the COVID-19 group compared to that in controls (P = .012). Significant correlations were found between the RNFL and VD of the SCP, DCP, RPC, and FAZ area in the COVID-19 group (P <.05). CONCLUSIONS: OCTA showed retinal vascular changes in subjects fully recovered from COVID-19 pneumonia. These findings could be a consequence of a thrombotic microangiopathy that affected retinal structures as well as other systemic organs. OCTA could represent a valid, noninvasive biomarker of early vascular dysfunction after SARS-CoV-2 infection.

COVID-19/epidemiology , Fluorescein Angiography/methods , Macula Lutea/pathology , Retinal Diseases/diagnosis , Retinal Vessels/diagnostic imaging , Tomography, Optical Coherence/methods , Capillaries/diagnostic imaging , Comorbidity , Female , Fundus Oculi , Humans , Male , Middle Aged , Pilot Projects , Prospective Studies , Retinal Diseases/epidemiology , SARS-CoV-2
Inflamm Res ; 69(8): 757-763, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-401592


The novel coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sorely testing health care systems and economies around the world and is rightly considered as the major health emergency in a century. Despite the course of the disease appearing to be mild in many cases, a significant proportion of symptomatic patients develop pneumonia requiring hospitalisation or progress to manifest respiratory complications leading to intensive care treatment. Potential interventions for SARS-CoV2-associated pneumonia are being tested, some of which holding promise, but as of today none of these has yet demonstrated outstanding efficacy in treating COVID-19. In this article, we discuss fresh perspectives and insights into the potential role of immune dysregulation in COVID-19 as well as similarities with systemic inflammatory response in sepsis and the rationale for exploring novel treatment options affecting host immune response.

Coronavirus Infections/diagnosis , Coronavirus Infections/immunology , Immune System/virology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/immunology , Sepsis/diagnosis , Sepsis/immunology , Betacoronavirus , Biomarkers , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/therapy , Cytokine Release Syndrome/virology , Cytokines/immunology , Humans , Immunity, Innate , Inflammation , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , SARS-CoV-2 , Sepsis/complications , Sepsis/therapy