Microvascular Angiopathic Consequences of COVID-19

Nalugo, Margaret; Schulte, Linda; Masood, Muhammad; Zayed, Mohamed A.

doi:10.3389/fcvm.2021.636843

Cited by 29 publications

(23 citation statements)

References 119 publications

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“…During and shortly after the acute phase of the infection most of the organ dysfunctions have been attributed to microvascular angiopathy [ 31 ]. Therefore, following the microvascular changes over time seems relevant during the recovery phase of the disease.…”

Section: Discussionmentioning

confidence: 99%

Persistent Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia at 6-Months Follow-Up Assessed by Optical Coherence Tomography Angiography

et al. 2021

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The purpose of this study was to evaluate the long-term evolution of retinal changes in COVID-19 patients with bilateral pneumonia. A total of 17 COVID-19 patients underwent retinal imaging 6 months after hospital discharge with structural optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). The parafoveal retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) were significantly thinner in COVID-19 patients at 6 months compared to 0 months (p = <0.001 in both cases). In the optic nerve analysis, a significantly thinner RNFL was observed (p = 0.006) but persisted significantly thickened, compared to controls (p = 0.02). The vascular density (VD) at 6 months persisted significantly decreased when compared to the control group, and no significant differences were found with the 0 months evaluation; in addition, when analyzed separately, women showed a worsening in the VD. Moreover, a significantly greater foveal area zone (FAZ) (p = 0.003) was observed in COVID-19 patients at 6 months, compared to 0 months. The cotton wool spots (CWSs) observed at baseline were no longer present at 6 months, except for one patient that developed new ones. This study demonstrates that some of the previously known microvascular alterations resulting from COVID-19, persist over time and are still evident 6 months after hospital discharge in patients who have suffered from bilateral pneumonia.

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Section: Discussionmentioning

confidence: 99%

Persistent Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia at 6-Months Follow-Up Assessed by Optical Coherence Tomography Angiography

et al. 2021

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“…Inflammation can cause overexpression of adhesion molecules on the endothelial cells through inflammatory cytokines. Endothelial dysfunction is the ultimate outcome of the interaction between proinflammatory cytokines and endothelial cells [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Macular vessel density reduction in patients recovered from COVID-19: a longitudinal optical coherence tomography angiography study

Abrishami

Hassanpour

Hosseini

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Background/aims To quantify the longitudinal changes of the macular microvasculature and the foveal avascular zone (FAZ) parameters in patients recovered from coronavirus disease-2019 (COVID-19) using optical coherence tomography angiography (OCTA) analysis. Methods This observational, longitudinal study was performed on patients recovered from COVID-19. The OCTA images were recorded at baseline and after 1 and 3 months at the follow-up examination. Vessel density (VD) of the retinal superficial (SCP) and deep capillary plexus (DCP), as well as the area of the FAZ of patients who had recovered from COVID-19, were measured. Results In total, 36 eyes of 18 patients (62.2% female) with a mean age of 34.5 ± 7.5 years old were included. Regarding SCP, while the VDs of the whole image, fovea, and parafovea were comparable at different time points, the mean VDs in inferior hemifield, as well as superior and inferior regions of perifovea, underwent significant reductions at month 3, compared to the baseline. In DCP, the mean of VD in the whole image was 54.3 ± 2.7 at the first visit which significantly decreased to 52.1 ± 3.8( P = 0.003) and 51.4 ± 2.7( P = 0.001) after 1 and 3 months, respectively. The VDs in all regions of parafovea and perifovea revealed a significant reduction after 1 and 3 months, compared to the first visit. The mean FAZ area was 0.27 ± 0.08 mm 2 , 0.26 ± 0.08 mm 2 , and 0.27 ± 0.08 mm 2 at the baseline, month 1, and month 3, respectively ( P > 0.05). Conclusion Based on the results, the patients who had recovered from COVID-19 had a progressive decrease of VD at the follow-up visit 3 months after COVID-19 infection.

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“…Many studies have published the role of microvascular thrombus in SARS-CoV-2 infection. [17][18][19][20] There is a definite link between inflammation, hypercoagulation, and thrombosis, according to previous research. Part of this interaction is likely mediated by a cytokine storm, which increases the risk of developing disseminated intravascular coagulopathy.…”

Section: Discussionmentioning

confidence: 85%

“…21 The stimulation of coagulation pathways throughout the body by mediators produced during a cytokine storm can result in a prothrombotic condition marked by the formation of microthrombi, diffuse capillary blockage, tissue ischemia, and organ damage. 18 This pathogenesis indicates the possible tendency for physiopathology of glans penile necrosis secondary to SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 96%

Case Report: Glans penile necrosis in a patient with SARS-CoV-2 and leprosy infection

2022

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was firstly identified in China and has been declared a global pandemic. Several serious extrapulmonary manifestations due to SARS-CoV-2 infection have also been reported and associated with hypercoagulability thrombotic vasculopathy. In addition, cases of Mycobacterium-leprae infection have also been known associated with blood coagulation abnormality. Methods: Here, we report a 56-year-old male with coronavirus disease-19 (COVID-19) with concomitant leprosy infection with manifestation of glans penile necrosis, presented to the emergency department with acute penile pain. This case is unique because no occlusion blood flow to the penile was observed in the radiographic imaging. We described the potential pathophysiology in this case through a literature review. Results: The patient received treatment according to the COVID-19 protocol and was given low molecular weight heparin (LMWH) therapy for 4 days. During the follow up, the clinical and functional condition of the penis showed significant improvement. Conclusions: Microthrombus involvement, platelet abnormalities and impaired hemostasis due to SARS-CoV-2 and leprosy co-infection are the hypothesis in this case report.

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Microvascular Angiopathic Consequences of COVID-19

Cited by 29 publications

References 119 publications

Persistent Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia at 6-Months Follow-Up Assessed by Optical Coherence Tomography Angiography

Persistent Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia at 6-Months Follow-Up Assessed by Optical Coherence Tomography Angiography

Macular vessel density reduction in patients recovered from COVID-19: a longitudinal optical coherence tomography angiography study

Case Report: Glans penile necrosis in a patient with SARS-CoV-2 and leprosy infection

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