Retinal vascular impairment matched to the pulmonary damage in early post-COVID 19 patients

摘要

Background Endothelium damage is a crucial element in the pathogenesis of SARS-Cov-2 infection. Most casualties in critical COVID-19 cases are due to ARDS, diffuse coagulopathy and cytokine storm. ARDS itself is a consequence of pulmonary endothelial cells damage. Damage to retinal capillary microcirculation in post-infective period has been investigated through Optical Coherence Tomography Angiography (OCTA). The aim of the present study is to find a correlation between signs of retinal vascular damage and pulmonary impairment. Methods Patients admitted to hospital and subsequently recovered from COVID-19 infection were summoned 1 month later to undergo coherence tomography (CT) scan and OCTA examination. Results The study population included 87 COVID-19 patients with a mean age of 54.28 +/- 14.44 years. Oxygen therapy, non-invasive and invasive mechanical ventilation were necessary in 33, 11 and 4 patients respectively to provide respiratory support during the acute course of the disease. Pulmonary involvement interested 54 patients (62.1). Peripheral (27.6) or diffuse (29.9) involvement and ground glass (GG) opacities (47.1) represented the prevalent radiological finding. A reduced RCPI FI was independently correlated with the presence of reticulation pattern in CT scan (p = .019). Also, RNFL and GCC were thinner in patients who displayed reticulation pattern (respectively p = .025 and p = .015). Conclusions A reduction in RPCP-FI and RNFL and GCC thickness were independently correlated to the presence of CT reticulation pattern. This association can reflect cytokine induced remodeling in both organs as a consequence of systemic endothelial damage and inflammation.