• Medicina clinica · Jun 2021

    Reduced retinal vessel density in COVID-19 patients and elevated D-dimer levels during the acute phase of the infection.

    • Noemi Guemes-Villahoz, Barbara Burgos-Blasco, Beatriz Vidal-Villegas, Juan Donate-López, Francisco Javier Martín-Sánchez, Jesús Porta-Etessam, Lorenzo López-Guajardo, José Luis R Martín, Juan Jorge González-Armengol, and Julián García-Feijoó.
    • Servicio de Oftalmología, Hospital Clínico San Carlos; Instituto de investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. Electronic address: noemiguemes@gmail.com.
    • Med Clin (Barc). 2021 Jun 11; 156 (11): 541-546.

    PurposeTo describe macular vessel density and perfusion in COVID-19 patients using coherence tomography angiography (OCTA) and to investigate whether there is a correlation between retinal vascular abnormalities and clinical and laboratory parameters.MethodsCross-sectional analysis conducted at the Hospital Clinico San Carlos in Madrid, Spain. Patients with laboratory-confirmed COVID-19 that were attended in the Emergency Department (ED) from March 23 to March 29, 2020 were included. Fundus examination and OCTA were performed 4 weeks after being attended in ED. Macular OCTA parameters were analyzed and correlated with clinical (severity and hypoxemia- oxygen saturation<92%) and laboratory parameters during hospital stay (D-Dimer-DD, lactate dehydrogenase-LDH and C-reactive protein-CRP).Results80 patients were included, mean age 55(SD9) years old; 46.3% male. We reported macular vessel density and perfusion measurements in COVID-19 patients. Those patients with D-Dimer≥500ng/ml during SARS-CoV-2 infection had a decrease of central vessel density (mean difference 2.2; 95%CI 0.4-3.9) and perfusion density (mean difference 4.9; 95%CI 0.9-8.9) after the acute phase of COVID-19. These variations of vessel density and perfusion density were not documented in patients with LDH≥500U/L, CRP≥10mg/L and hypoxemia.ConclusionsCOVID-19 patients showed short-term retinal vasculature abnormalities which may be related to a prothrombotic state associated with SARS-CoV-2 infection. Since the retinal microvasculature shares many morphological and physiological properties with the vasculature of other vital organs, further research is needed to establish whether patients with increased D-Dimer levels require more careful assessment and follow-up after COVID-19.Copyright © 2021 Elsevier España, S.L.U. All rights reserved.

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