COVID‐19 retinal microangiopathy as an in vivo biomarker of systemic vascular disease?

• DOI: 10.1111/joim.13156
• Publication Date: 2020-07-30T10:14:17Z
• Authors: M. F. Landecho; J. R. Yuste; E. Gándara; P. Sunsundegui; J. Quiroga; A. B. Alcaide; A. García‐Layana
• Keywords: Male; Fundus Oculi; SARS-CoV-2; COVID-19; Comorbidity; Middle Aged; Retina; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Retinal Diseases; Cardiovascular Diseases; Internal Medicine; Humans; Female; Prospective Studies; Fluorescein Angiography; Pandemics; Tomography, Optical Coherence; Follow-Up Studies

AbstractImportanceCOVID‐19 is caused by SARS‐CoV‐2, a betacoronavirus that uses the angiotensin‐converting enzyme‐related carboxypeptidase (ACE2) receptor to gain entry into cells. ACE2 receptor is widely expressed in multiple organs, including the retina, an extension of the central nervous system. The ACE2 receptor is involved in the diabetic and hypertensive retinopathy. Additionally, coronaviruses cause ocular infections in animals, including retinitis, and optic neuritis.ObjectiveTo assess whether there is any retinal disease associated with COVID‐19.DesignWe have evaluated 27 asymptomatic subjects, with retinal fundoscopic, optical coherence tomography (OCT) and OCT angiography fourteen days after hospital discharge due to COVID‐19 bilateral pneumonia.ResultsCotton wool exudates were evident in six out of 27 patients evaluated, a 22%. Cotton wool exudates are a marker vascular disease severity in other medical context, that is diabetes and hypertension, and are associated with increased risk for acute vascular events. Whether antiaggregation therapy may play a role on fundoscopic‐selected patients with COVID‐19 requires prospective trials.