COVID-19-related retinal microvasculopathy and systemic implications in patients with severe disease: results from the Methuselah study, 2024, Castell

COVID-19-related retinal microvasculopathy and systemic implications in patients with severe disease: results from the Methuselah study
Castellino, Niccolò; Longo, Antonio; Russo, Andrea; Bonfiglio, Vincenza; Fallico, Matteo; Toro, Mario Damiano; Cappellani, Francesco; Grillo, Marco; Gaudio, Agostino; Lo Cicero, Lorenzo; Sessa, Concetto; Colaci, Michele; Malatino, Lorenzo; Castellino, Pietro; Avitabile, Teresio; Zanoli, Luca

Objectives
To assess the reversibility of retinal microvascular changes in the long-term and to investigate potential links with other vascular diseases of COVID-19.

Methods
Prospective multicenter observational study. Patients were enrolled from the Methuselah study cohort. Retinal vascular function was studied using Optical Coherence Tomography Angiography (OCTA); aortic stiffness was measured using aortic pulse wave velocity. These examinations were performed 1 (Visit 1) and 12 (Visit 2) months after the hospital discharge for severe COVID-19. A control subject group matched for age and sex was included to define normal values.

Results
A total of 28 control subjects (56 eyes) and 25 patients (50 eyes) completed the scheduled OCTA assessment; 18 patients (36 eyes) also completed the macrovascular examination. Compared to controls, the vessel density of the superficial capillary plexus (SCP) was reduced whereas the foveal avascular zone area was enlarged at Visit 1 (p=0.016 and <0.001, respectively) and were not modified after the 12 months follow-up in COVID-19 patients (p=0.011 and 0.001, respectively). Higher inflammation and lower renal function during hospitalization were linked to higher aortic stiffness and reduced vessel density of the SCP 1 month after the acute phase of COVID-19. A slower recovery of aortic dysfunction was linked to worst retinal vascular outcomes at Visit 2.

Conclusions
Retinal vascular alterations were not reversible 12 months after COVID-19 and were linked to inflammation and renal dysfunction during hospitalization, as well as to aortic stiffness measured during follow-up.

Link | PDF (Frontiers in Medicine)

 

Hospitalised patients.