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Retinal findings in patients with COVID-19: Results from the SERPICO-19 study.
Invernizzi, Alessandro; Torre, Alessandro; Parrulli, Salvatore; Zicarelli, Federico; Schiuma, Marco; Colombo, Valeria; Giacomelli, Andrea; Cigada, Mario; Milazzo, Laura; Ridolfo, Annalisa; Faggion, Ivano; Cordier, Laura; Oldani, Marta; Marini, Sara; Villa, Paolo; Rizzardini, Giuliano; Galli, Massimo; Antinori, Spinello; Staurenghi, Giovanni; Meroni, Luca.
  • Invernizzi A; Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Torre A; Department of Biomedical and Clinical Sciences "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
  • Parrulli S; The Discipline of Clinical Ophthalmology and Eye Health, Save Sight Institute, Sydney Eye Hospital, Faculty of Medicine and Health, The University of Sydney, 8 Macquarie Street, Sydney, NSW 2001, Australia.
  • Zicarelli F; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Schiuma M; Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Colombo V; Department of Biomedical and Clinical Sciences "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
  • Giacomelli A; Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Cigada M; Department of Biomedical and Clinical Sciences "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
  • Milazzo L; Department of Biomedical and Clinical Sciences "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
  • Ridolfo A; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Faggion I; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Cordier L; Department of Biomedical and Clinical Sciences "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
  • Oldani M; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Marini S; Department of Biomedical and Clinical Sciences "L. Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
  • Villa P; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Rizzardini G; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Galli M; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Antinori S; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Staurenghi G; Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Meroni L; Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
EClinicalMedicine ; 27: 100550, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-778782
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Fundus PART_OF Patients
Subject
Fundus
Predicate
PART_OF
Object
Patients
3. COVID-19 AFFECTS Patients
Subject
COVID-19
Predicate
AFFECTS
Object
Patients
4. COVID-19 COEXISTS_WITH Borg Category-Ratio 10 Perceived Exertion Score 5
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
Borg Category-Ratio 10 Perceived Exertion Score 5
5. Evaluation procedure TREATS COVID-19
Subject
Evaluation procedure
Predicate
TREATS
Object
COVID-19
6. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
7. Fundus PART_OF Patients
Subject
Fundus
Predicate
PART_OF
Object
Patients
8. COVID-19 AFFECTS Patients
Subject
COVID-19
Predicate
AFFECTS
Object
Patients
9. COVID-19 COEXISTS_WITH Borg Category-Ratio 10 Perceived Exertion Score 5
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
Borg Category-Ratio 10 Perceived Exertion Score 5
10. Evaluation procedure TREATS COVID-19
Subject
Evaluation procedure
Predicate
TREATS
Object
COVID-19
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) has been associated to microvascular alterations. We screened the fundus of patients with COVID-19 to detect alterations of the retina and its vasculature and to assess possible correlations with clinical parameters.

METHODS:

Cross-sectional study. The presence of retinal alterations in patients with COVID-19 and subjects unexposed to the virus was assessed using fundus photographs and their prevalence was compared. Mean arteries diameter (MAD) and mean veins diameter (MVD) were compared between patients and unexposed subjects with multiple linear regression including age, sex, ethnicity, body mass index, smoking/alcohol consumption, hypertension, hyperlipidaemia, diabetes as covariates. The influence of clinical/lab parameters on retinal findings was tested in COVID-19 patients.

FINDINGS:

54 patients and 133 unexposed subjects were enrolled. Retinal findings in COVID-19 included haemorrhages (9·25%), cotton wools spots (7·4%), dilated veins (27·7%), tortuous vessels (12·9%). Both MAD and MVD were higher in COVID-19 patients compared to unexposed subjects (98·3 ± 15·3 µm vs 91·9 ± 11·7 µm, p = 0.006 and 138·5 ± 21·5 µm vs 123·2 ± 13·0 µm, p<0.0001, respectively). In multiple regression accounting for covariates MVD was positively associated with COVID-19 both in severe (coefficient 30·3, CI95% 18·1-42·4) and non-severe (coefficient 10·3, CI95% 1·6-19·0) cases compared to unexposed subjects. In COVID-19 patients MVD was negatively correlated with the time from symptoms onset (coefficient -1·0, CI 95% -1·89 to -0·20) and positively correlated with disease severity (coefficient 22·0, CI 95% 5·2-38·9).

INTERPRETATION:

COVID-19 can affect the retina. Retinal veins diameter seems directly correlated with the disease severity. Its assessment could have possible applications in the management of COVID-19.

FUNDING:

None.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Randomized controlled trials / Risk factors Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100550

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Randomized controlled trials / Risk factors Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100550