COVID-19 News: Italian Researchers Find That SARS-CoV-2 Can Affect The Retina In The Eyes
: More and more each day we are learning of the various damaging and disastrous effects the SARS-CoV-2 coronavirus has on the human host body not only on those that are just infected and are going through severe conditions but also in term of long term health complications of those who had recovered from mild or moderate symptoms or were asymptomatic. The COVID-19 disease is now classified as a systemic infection, affecting multiple organs, tissues, cells and cellular pathways and processes.
A new study by Italian researchers from the Eye Clinic at Luigi Sacco Hospital, University of Milan, the Italian Department of Infectious Diseases and University of Sydney-Australia has found that the SARS-CoV-2 coronavirus also targets the retina of the eye.
The study findings has implications in terms of the possibility of deterioration of eye sight in the long term and warrants further investigation.
The study findings were published in the journal: EClinicalMedicine.
The new study initially aimed to determine if the COVID-19 disease affects the retina since the disease has been liked to microvascular alterations.
The Study team analyzed the retina of COVID-19 patients within 30 days from the start of the symptoms.
The study team screened the fundus of patients with COVID-19 to detect alterations of the retina and its vasculature to explore potential correlations with clinical parameters.
The team conducted the cross-sectional and monocentric study at the Luigi Sacco Hospital, Department of Biomedical and Clinical Science in Milan, Italy. (The European nation is one of the countries worse by COVID-19.)
The research participants included patients who were admitted to the infectious diseases department of the hospital, and who tested positive for SARS-CoV-2 infection. The team excluded patients admitted to the intensive care unit and those with retinal disorders, including diabetic retinopathy.
For the research, all patients had to complete questionnaires describing their ocular symptoms. They also underwent pupil dilation of both eyes using mydriatic drops about 15 minutes before the researchers captured retinal images.
A total of 54 patients and 133 unexposed participants were included in the study.
The study findings show that individuals with COVID-19 had retinal findings of hemorrhages, cotton wool spots, dilated veins, and tortuous vessels.
Significantly after the team measured the mean arteries diameter (MAD) and mean veins diameter (MVD) among the participants, they found that both the MAD and MVD were higher in patients with COVID-19 than unexposed participants.
Dr Alessandro Invernizzi, the corresponding author of the study and an ophthalmologists at the Eye Clinic at Luigi Sacco Hospital told Tha
iland Medical News, "We found that both retinal arteries and veins were larger compared to unexposed subjects. Besides, veins diameter was larger in more severe cases and showed an inverse correlation with time to symptoms onset.”
Dr Invernizzi added, "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.”
The detailed retinal findings of the 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).
Past studies have reported a link between COVID-19 and the eyes. However, this study provides a deeper understanding of the virus's effects, affecting the retina, vital for vision.
Retinal findings in Coronavirus Diseases 2019 patients. Dilated veins (white arrowheads) and tortuous vessels (black arrowheads) (A), a retinal haemorrhage (B) and a cotton wool spot (C) as seen on color fundus photos. Credit: Luigi Sacco Hospital
In summary, the stud team said that they found that COVID-19 can induce important changes at the level of the retina, most of them affecting the retinal vasculature and particularly veins. The entity of such changes was directly correlated with the disease severity and seemed to affect patients early in the disease course. They were not able to establish whether retinal changes were caused by the virus itself or by the immune response of the host. Nonetheless, if the data will be confirmed, retinal veins diameter could represent a useful parameter to monitor the inflammatory response and/or the endothelial damage in COVID-19. Considering the non-invasive nature of fundus examination, retinal changes should be further investigated in prospective studies to understand their possible applications in the diagnosis and management of COVID-19.
Also the resulting effects from the viral infection on the retina warrants further investigation to see if it affects the eye sight in the long term and to what degree ie blindness etc.
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