Seeking clarity on retinal findings in patients with COVID-19 – Authors' reply

Marinho, Paula; Nascimento, Heloísa; Marcos, Alléxya A A; Romanò, A; Belfort, Rubens

doi:10.1016/s0140-6736(20)31912-7

Cited by 14 publications

(12 citation statements)

References 5 publications

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“…A proven similarity with certainty in viral spread in human tissues and/ or fluids of SARS-CoV-2 would not only be concerning but also quite novel for its family. As recently described by Marinho et al [ 3 ], there might be retinal damage in the context of COVID-19, a finding the authors confirmed with a larger cohort of more than 150 patients [ 4 ]. Schnichels et al confirmed the presence of angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in retinal tissues [ 5 ].…”

Section: Introductionsupporting

confidence: 62%

“…Hence, in our small cohort of COVID-19 deceased patients retinal histpathology appeared normal. Further studies are needed to confirm or refute the results and should also include additional markers to detect immunopathological changes and inflammation in the eye, as also stated by Marinho et al [ 4 ].…”

Section: Discussionmentioning

confidence: 92%

“…The acute ischemic nature of the pathological changes might be reversible or might not. As stated by the original group, these retinal lesions appear to be part of an ischemic, microvascular process [ 4 ]. In accordance with this, we did not find any persistent pathological changes in individuals succumbed to COVID-19 in this series.…”

Section: Resultsmentioning

confidence: 99%

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Severe acute respiratory Syndrome-Coronavirus-2: Can it be detected in the retina?

Bayyoud

Iftner

et al. 2021

PLoS ONE

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Background/Objectives The systemic organ involvement of SARS-CoV-2 needs to be thoroughly investigated including the possibility of an ocular reservoir in humans. To examine retinal tissues and vitreous for histopathology and SARS-CoV-2 presence with regard to possible effects on the human retina and/ or vitreous. We performed histopathological analyses and quantitative (q)RT-PCR-testing for SARS-CoV-2 RNA on retinal tissues and vitreous of COVID-19 postmortem donors. Subjects/Methods Included in this study were 10 eyes of 5 deceased COVID-19 patients. The diagnosis of SARS-CoV-2 infection was confirmed via pharyngeal swabs and broncho-alveolar fluids. The highest level of personal protective equipment (PPE) and measures was employed during fluid-tissue procurement and preparation. Histopathological examinations and qRT-PCR-testing were carried out for all retinal tissues and vitreous fluids. Results The histopathological examinations revealed no signs of morphologically identifiable retinal inflammation or vessel occlusions based on hematoxylin and eosin stains. By qRT-PCRs, we detected no significant level of viral RNA in human retina and vitreous. Conclusions In this study, no significant level of SARS-CoV-2-RNA was detected in the human retinal and vitreous fluid samples of deceased COVID-19 patients. Histopathological examinations confirmed no morphological sign of damage to retinal vasculature or tissues. Further studies are needed to confirm or refute the results.

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Section: Introductionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 92%

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Severe acute respiratory Syndrome-Coronavirus-2: Can it be detected in the retina?

Bayyoud

Iftner

et al. 2021

PLoS ONE

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“…However, after further investigation and correspondence, the authors discovered that these hyperreflective lesions were found to have an absence of blood flow. 9 Both of the previously described funduscopic and OCT findings in patients with COVID-19 may be explained by viral invasion and subsequent immune-mediated inflammation. This results in wide spread microvascular ischaemia that affects many organs including the retina.…”

Section: Introductionmentioning

confidence: 93%

Fast Progression of Diabetic Retinopathy with SARS-CoV-2 Infection

2021

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COVID-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has been shown to affect a multitude of organ systems. It is often associated with vasculitis or thromboembolic disease with resultant tissue hypoxia. This report presents a case of fast progression diabetic retinopathy in the case of a SARS-CoV-2 infection. The findings conclude that patients with diabetes should be more frequently monitored for emergence or progression of diabetic retinopathy if they present with COVID-19.

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“…By 12 March 2020, the novel coronavirus (nCoV) outbreak achieved a global pandemic status and was recognised as novel like symptoms [5]. Recent study has shown formation of hyper-reflective lesions in the ganglion cell and inner plexiform layers of the retina particularly around the papillomacular bundles [6]. The disease has also been shown to affect sense of smell and taste bud sensitivity in patients [7].…”

Section: Introductionmentioning

confidence: 99%

Evolving geographic diversity in SARS-CoV2 and in silico analysis of replicating enzyme 3CLpro targeting repurposed drug candidates

et al. 2020

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Background Severe acute respiratory syndrome (SARS) has been initiating pandemics since the beginning of the century. In December 2019, the world was hit again by a devastating SARS episode that has so far infected almost four million individuals worldwide, with over 200,000 fatalities having already occurred by mid-April 2020, and the infection rate continues to grow exponentially. SARS coronavirus 2 (SARS-CoV-2) is a single stranded RNA pathogen which is characterised by a high mutation rate. It is vital to explore the mutagenic capability of the viral genome that enables SARS-CoV-2 to rapidly jump from one host immunity to another and adapt to the genetic pool of local populations. Methods For this study, we analysed 2301 complete viral sequences reported from SARS-CoV-2 infected patients. SARS-CoV-2 host genomes were collected from The Global Initiative on Sharing All Influenza Data (GISAID) database containing 9 genomes from pangolin-CoV origin and 3 genomes from bat-CoV origin, Wuhan SARS-CoV2 reference genome was collected from GeneBank database. The Multiple sequence alignment tool, Clustal Omega was used for genomic sequence alignment. The viral replicating enzyme, 3-chymotrypsin-like cysteine protease (3CLpro) that plays a key role in its pathogenicity was used to assess its affinity with pharmacological inhibitors and repurposed drugs such as anti-viral flavones, biflavanoids, anti-malarial drugs and vitamin supplements. Results Our results demonstrate that bat-CoV shares > 96% similar identity, while pangolin-CoV shares 85.98% identity with Wuhan SARS-CoV-2 genome. This in-depth analysis has identified 12 novel recurrent mutations in South American and African viral genomes out of which 3 were unique in South America, 4 unique in Africa and 5 were present in-patient isolates from both populations. Using state of the art in silico approaches, this study further investigates the interaction of repurposed drugs with the SARS-CoV-2 3CLpro enzyme, which regulates viral replication machinery. Conclusions Overall, this study provides insights into the evolving mutations, with implications to understand viral pathogenicity and possible new strategies for repurposing compounds to combat the nCovid-19 pandemic.

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Seeking clarity on retinal findings in patients with COVID-19 – Authors' reply

Cited by 14 publications

References 5 publications

Severe acute respiratory Syndrome-Coronavirus-2: Can it be detected in the retina?

Severe acute respiratory Syndrome-Coronavirus-2: Can it be detected in the retina?

Fast Progression of Diabetic Retinopathy with SARS-CoV-2 Infection

Evolving geographic diversity in SARS-CoV2 and in silico analysis of replicating enzyme 3CLpro targeting repurposed drug candidates

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