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COVID-19 hemodynamic and thrombotic effect on the eye microcirculation after hospitalization: A quantitative
Aristotle G Koutsiaris1, Konstantina Riri2, Stylianos Boutlas3
1Medical Informatics Laboratory, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece.
Insights
COVID-19 survivors show significantly reduced eye blood flow and increased microthrombosis, even with preventative treatment. This may explain long COVID symptoms and suggest new coagulation factors.
Area of Science:
- Ophthalmology
- Vascular Biology
- Infectious Diseases
Background:
- COVID-19 can affect microcirculation, leading to potential long-term complications.
- Understanding these effects is crucial for managing post-hospitalization recovery.
Purpose of the Study:
- To quantify the hemodynamic and thrombotic impact of COVID-19 on ocular microcirculation.
- To assess these effects in patients receiving thromboprophylaxis after hospital discharge.
Main Methods:
- A case-control study comparing 17 COVID-19 survivors with 17 healthy controls.
- Conjunctival Video Capillaroscopy (CVC) used to measure axial blood velocity (Vax) and percentage of occluded vessels (POV).
- Microvessels analyzed included capillaries (CAP), postcapillary venules size 1 (PC1), and size 2 (PC2).
Main Results:
- COVID-19 survivors exhibited significantly reduced Vax (39-47%) across all analyzed microvessel types compared to controls.
- A substantial increase in POV (600%) was observed in COVID-19 survivors.
- Demographics between the COVID-19 and control groups were comparable.
Conclusions:
- COVID-19 significantly impairs ocular microvascular blood flow and promotes microthrombosis, even with thromboprophylaxis.
- These findings offer a potential explanation for persistent symptoms in long COVID.
- The results suggest the possible involvement of an unidentified coagulation factor in COVID-19's vascular effects.
Background & Objective:
To quantify the hemodynamic and thrombotic effect of COVID-19 on the eye microcirculation of patients with thromboprophylaxis, shortly after hospital discharge.
Methods:
This case-control study included 17 COVID-19 survivors (named "COVID-19 Group") and 17 healthy volunteers (named "Control Group"). Axial blood velocity (Vax) and percentage of occluded vessels (POV) were quantified by Conjunctival Video Capillaroscopy (CVC). Microvessels were identified and classified as "capillaries" (CAP), "postcapillary venules of size 1" (PC1), and "postcapillary venules of size 2" (PC2).
Results:
The COVID-19 Group did not differ significantly in basic demographics from the Control Group. In the COVID-19 Group, there was a statistically significant (p < 0.001) reduction of Vax (39%, 49% and 47%, for CAP, PC1, and PC2, respectively) in comparison to the Control Group and a sizeable (p < 0.001) increase of POV (600%) in comparison to the Control Group.
Conclusions:
COVID-19 not only reduces significantly axial blood velocity in the capillaries and postcapillary venules of the eye but has also a devastating effect on microthrombosis (POV) despite thromboprophylaxis treatment. This gives a possible explanation for long COVID and a hint about the existence of a possibly unknown coagulation factor.
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