BREAKING COVID-19 News! SARS-CoV-2 Induced Retinal Microvascular Damage Is Not Reversible! Many Will Eventually Become Blind!

COVID-19 News: The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has left an indelible mark on global health. While primarily known for its respiratory impact, emerging research suggests profound implications on vascular health, particularly within the microvasculature of the retinal bed in the eyes. The Methuselah study that is covered in this COVID-19 News report, conducted by esteemed researchers from the University of Catania, University of Palermo, and Medical University of Lublin, delves into the long-term effects of COVID-19 on retinal microvascular alterations and their potential systemic ramifications.


SARS-CoV-2 Induced Retinal Microvascular Damage Is Not Reversible
 
Unknown to many, SARS-CoV-2 can cause a variety of serious eye issues directly and indirectly that can potentially cause vision. (Refer to studies at the end of the article). Thailand Medical News had recently covered studies showing that SARS-Cov-2 exposure can lead to glaucoma!
 
https://www.thailandmedical.news/news/breaking-covid-19-news-chinese-study-discovers-that-sars-cov-2-increases-the-risk-for-developing-acute-angle-closure-glaucoma
 
https://www.thailandmedical.news/news/breaking-covid-19-news-study-claims-that-omicron-infections-can-lead-to-acute-primary-angle-closure-and-also-primary-angle-closure-glaucoma
 
Optical Coherence Tomography Angiography (OCTA) as a Window into the Retinal Microvasculature
OCTA, a non-invasive retinal imaging technique, has proven invaluable in assessing systemic diseases' impact on the retina and neovascular network. Prior studies using OCTA during the acute phase of COVID-19 revealed varying degrees of retinal vascular damage, dependent on disease severity. However, the Methuselah study stands out by focusing on the long-term effects, investigating the reversibility of retinal microvascular changes over a 12-month period post-hospital discharge for severe COVID-19.
 
Study Design and Patient Characteristics
The prospective multicenter observational study enrolled patients from the Methuselah study cohort, including 25 individuals hospitalized for severe COVID-19 and a control group of 28 subjects. The study aimed to evaluate retinal vascular function using OCTA and measure aortic stiffness through aortic pulse wave velocity at two time points: one month (Visit 1) and twelve months (Visit 2) post-hospital discharge.
 
Key Findings
The study's find ings paint a grim picture of the long-term consequences of COVID-19 on retinal microvascular health. At Visit 1, compared to controls, COVID-19 patients exhibited reduced vessel density in the superficial capillary plexus (SCP) and an enlarged foveal avascular zone (FAZ). Strikingly, these alterations persisted unchanged at Visit 2, indicating the irreversibility of retinal microvascular changes a year after severe COVID-19.
 
Association with Systemic Factors
The study revealed intriguing associations between retinal microvascular alterations and systemic factors. Higher inflammation and lower renal function during hospitalization were linked to increased aortic stiffness and reduced vessel density of the SCP one month after the acute phase of COVID-19. Furthermore, a slower recovery of aortic dysfunction was associated with worse retinal vascular outcomes at Visit 2, emphasizing the intricate interplay between systemic and ocular manifestations of COVID-19.
 
Retinal Microvascular Alterations Or Damage Is Also Found In Those With Asymptomatic and Mild COVID-19 Infections
Thailand Medical News would like add that while the study focused only on individuals who had severe COVID-19, it should be noted that studies have shown that even those had asymptomatic or mild COVID-19 infections are also at risk of retinal microvascular alterations or damage!
https://www.thailandmedical.news/news/breaking-covid-19-news-turkish-researchers-shockingly-find-that-sars-cov-2-causes-changes-in-the-vascular-structures-of-the-eyes
 
https://www.sciencedirect.com/science/article/pii/S0002939421004761
 
https://www.cureus.com/articles/153100-branch-retinal-vein-occlusion-after-covid-19-infection-a-case-report#!/
 
https://www.nature.com/articles/s41598-021-98873-1
 
https://www.thailandmedical.news/news/breaking-news-polish-study-finds-that-sars-cov-2-infections-can-lead-to-changes-in-retinal-and-choroidal-blood-vessels-of-the-eyes
 
Also, as the mRNA COVID-19 vaccines contain the spike proteins of the SARS-CoV-2 virus, these vaccines can also induce retinal microvascular damage as well!
https://www.dovepress.com/retinal-changes-after-covid-19-infection-and-covid-19-vaccination-peer-reviewed-fulltext-article-IMCRJ
 
https://www.nature.com/articles/s41541-023-00661-7
 
https://www.mdpi.com/2076-393X/10/12/2143
 
https://www.hcplive.com/view/new-retinal-vascular-occlusion-rare-mrna-covid-19-vaccination
 
Furthermore, with viral persistence, the damage taking place at could be at a slower and undetected phase!
 
Insights into Short-Term and Long-Term Interconnections
Two distinct studies within the Methuselah study shed light on the short-term and long-term interconnections between renal, retinal microvascular, and macrovascular abnormalities in severe COVID-19 patients. Short-term analysis, conducted one month after acute infection, indicated a link between lower estimated glomerular filtration rate (eGFR) during hospitalization and reduced SCP vessel density at Visit 1. Long-term findings, at 12 months post-acute phase, revealed associations between lower eGFR improvement, increased FAZ, and rising aortic pulse wave velocity.
 
Implications for Vision and Vascular Health
The revelation that retinal vascular alterations induced by COVID-19 remain irreversible a year after the acute phase raises concerns about potential vision loss. The persistent reduction in vessel density, particularly in the SCP, underscores the severity of the impact on the microvascular bed. Furthermore, the study suggests a complex web of interactions between inflammation, renal dysfunction, and vascular stiffness, hinting at systemic repercussions of COVID-19 beyond the respiratory system.
 
Discussion - Unraveling the Mechanisms and Implications
The Methuselah study significantly contributes to our understanding of the long-term consequences of COVID-19 on retinal microvascular health. The observed irreversibility of retinal changes raises questions about the underlying mechanisms, possibly related to thromboinflammation reported during the acute phase. The study's strengths lie in its prospective design, providing insights into causality and temporality, and its comprehensive evaluation of both microvascular and macrovascular beds.
 
However, the study has limitations, including a relatively small sample size and the absence of baseline assessments before COVID-19. The lack of data on ophthalmic and aortic stiffness during the acute phase of infection poses challenges in fully understanding the progression of retinal alterations.
 
Additionally, the study acknowledges the need for longer follow-ups to determine the extent of reversibility of retinal lesions and to validate its findings through larger longitudinal studies.
 
Conclusion: A Harbinger of Ocular and Systemic Consequences
In conclusion, the Methuselah study forewarns of the ominous and irreversible consequences of COVID-19 on retinal microvascular health. The persistent retinal alterations, coupled with associations with inflammation, renal dysfunction, and vascular stiffness, signify a broader impact on systemic vascular health. As the world grapples with the aftermath of the pandemic, this study urges continued research, emphasizing the importance of long-term monitoring and interventions to mitigate potential vision loss and systemic vascular complications in survivors of severe COVID-19.
 
The study findings were published in the peer reviewed journal: Frontiers in Medicine.
https://www.frontiersin.org/articles/10.3389/fmed.2024.1294432/full
 
For the latest COVID-19 News, keep on logging to Thailand Medical News.
 
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