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Retinal changes in COVID-19 hospitalized cases
The main objective of this study was to evaluate the retinas of severely or critically ill COVID-19 patients during their hospital stay, at varying time points after symptoms onset. This was a case series observed during May 2020 in two referral centers for COVID-19 treatment in Rio de Janeiro, Braz...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714146/ https://www.ncbi.nlm.nih.gov/pubmed/33270751 http://dx.doi.org/10.1371/journal.pone.0243346 |
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author | Lani-Louzada, Rafael Ramos, Carolina do Val Ferreira Cordeiro, Ricardo Mello Sadun, Alfredo A. |
author_facet | Lani-Louzada, Rafael Ramos, Carolina do Val Ferreira Cordeiro, Ricardo Mello Sadun, Alfredo A. |
author_sort | Lani-Louzada, Rafael |
collection | PubMed |
description | The main objective of this study was to evaluate the retinas of severely or critically ill COVID-19 patients during their hospital stay, at varying time points after symptoms onset. This was a case series observed during May 2020 in two referral centers for COVID-19 treatment in Rio de Janeiro, Brazil. 47 eyes from 25 hospitalized patients with severe or critical confirmed illness were evaluated. A handheld retinal camera was used to acquire bilateral fundus images at several time points after symptoms onset. Electronic health records were retrospectively analyzed and clinical data collected. Severe and critical diseases were noticed in 52% (13/25) and 48% (12/25) of enrolled patients, respectively. Retinal changes were present in 12% (3/25) of patients: a 35 year-old male demonstrated bilateral nerve fiber layer infarcts and microhemorrhages in the papillomacular bundle, but required mechanical ventilation and developed severe anemia and systemic hypotension, acute kidney injury and neurologic symptoms during the course of the disease (critical illness); a 56 year-old male, who required full enoxaparin anticoagulation due to particularly elevated D-dimer (>5.0 mcg/mL), demonstrated unilateral and isolated flame-shaped hemorrhages; and a 49 year-old hypertensive male showed bilateral and discrete retinal dot and blot microhemorrhages. The other 22 patients evaluated did not demonstrate convincing retinal changes upon examination. There was no correlation between disease severity and admission serum levels of CRP, D-dimer and ferritin. This was the first study to show that vascular retinal changes may be present in not insignificant numbers of severe or critical COVID-19 inpatients. These retinal changes, only seen after morbid developments, were likely secondary to clinical intercurrences or comorbidities instead of a direct damage by SARS-CoV-2, and may be important and easily accessible outcome measures of therapeutic interventions and sentinels of neurologic and systemic diseases during COVID-19 pandemic. |
format | Online Article Text |
id | pubmed-7714146 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-77141462020-12-09 Retinal changes in COVID-19 hospitalized cases Lani-Louzada, Rafael Ramos, Carolina do Val Ferreira Cordeiro, Ricardo Mello Sadun, Alfredo A. PLoS One Research Article The main objective of this study was to evaluate the retinas of severely or critically ill COVID-19 patients during their hospital stay, at varying time points after symptoms onset. This was a case series observed during May 2020 in two referral centers for COVID-19 treatment in Rio de Janeiro, Brazil. 47 eyes from 25 hospitalized patients with severe or critical confirmed illness were evaluated. A handheld retinal camera was used to acquire bilateral fundus images at several time points after symptoms onset. Electronic health records were retrospectively analyzed and clinical data collected. Severe and critical diseases were noticed in 52% (13/25) and 48% (12/25) of enrolled patients, respectively. Retinal changes were present in 12% (3/25) of patients: a 35 year-old male demonstrated bilateral nerve fiber layer infarcts and microhemorrhages in the papillomacular bundle, but required mechanical ventilation and developed severe anemia and systemic hypotension, acute kidney injury and neurologic symptoms during the course of the disease (critical illness); a 56 year-old male, who required full enoxaparin anticoagulation due to particularly elevated D-dimer (>5.0 mcg/mL), demonstrated unilateral and isolated flame-shaped hemorrhages; and a 49 year-old hypertensive male showed bilateral and discrete retinal dot and blot microhemorrhages. The other 22 patients evaluated did not demonstrate convincing retinal changes upon examination. There was no correlation between disease severity and admission serum levels of CRP, D-dimer and ferritin. This was the first study to show that vascular retinal changes may be present in not insignificant numbers of severe or critical COVID-19 inpatients. These retinal changes, only seen after morbid developments, were likely secondary to clinical intercurrences or comorbidities instead of a direct damage by SARS-CoV-2, and may be important and easily accessible outcome measures of therapeutic interventions and sentinels of neurologic and systemic diseases during COVID-19 pandemic. Public Library of Science 2020-12-03 /pmc/articles/PMC7714146/ /pubmed/33270751 http://dx.doi.org/10.1371/journal.pone.0243346 Text en © 2020 Lani-Louzada et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Lani-Louzada, Rafael Ramos, Carolina do Val Ferreira Cordeiro, Ricardo Mello Sadun, Alfredo A. Retinal changes in COVID-19 hospitalized cases |
title | Retinal changes in COVID-19 hospitalized cases |
title_full | Retinal changes in COVID-19 hospitalized cases |
title_fullStr | Retinal changes in COVID-19 hospitalized cases |
title_full_unstemmed | Retinal changes in COVID-19 hospitalized cases |
title_short | Retinal changes in COVID-19 hospitalized cases |
title_sort | retinal changes in covid-19 hospitalized cases |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714146/ https://www.ncbi.nlm.nih.gov/pubmed/33270751 http://dx.doi.org/10.1371/journal.pone.0243346 |
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