141. Retinal endothelial dysfunction in patients with acute COVID-19 and three months post-infection
Creators: name: Tschuppert1, Scott
name: Todorova1, Margarita G.
name: Valmaggia1, Christophe
name: Neumann2, Thomas
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background:</strong> Infection with SARS-CoV-2 can lead to severe organ dysfunction. Vascular involvement has been postulated early during COVID-19 pandemic. Endothelial activation and dysfunction by altering the integrity of vessel barrier, promoting pro-coagulative state, endothelial inflammation, and mediation of leukocyte infiltration is critical for disease progression. Retinal vessel analysis (RVA) provides insight into endothelial function. Static and dynamic parameters are reliable markers for systemic vascular alterations. The aim of our study was to assess the endothelial function of the retinal vessels in patients with acute COVID-19 and three months post-infection. <strong>Methods:</strong> Patients with PCR proven SARS-CoV-2 infection and a NIAID-OS (National Institute of Allergy and Infectious Disease Ordinal Scale) score ³3 were included. Study visits were performed at the end of hospitalisation for severe infection and three month later for follow-up. Results are preliminary, as the study is still ongoing. All patients underwent retinal vessel analysis (RVA, iMEDOS Health GmbH, Germany) for investigation of static and dynamic retinal vessel parameters. Endothelial function was compared to normative data from age matched healthy individuals. Correlation of endothelial parameters with disease severity was sought. At 3 months after infection, all parameters were analysed again and compared to baseline. <strong>Results:</strong> 31 patients (mean age 58 years, 8 female) were included. So far, 19 patients completed the 3 months visit, one patient died during follow-up (malignancy) and one was lost to follow-up. Median NIAID-OS score was 5 (range 4 - 7, SD ± 1), mean duration from first symptoto hospitalisation 8.4 ± 3.0 day and lenght of hospitalisation 13.7 ± 10.1 days. Nine patients required intensive care with a mean ICU time of 11.2 ± 6.0 days, 6 patients were on mechanical ventilation (mean 11.7 ± 1.7 days). Oxygen was required in 23 (74%) patients (mean 12.0 ± 8.7 days). Mean body mass index (BMI) was 27.2 ± 3.1 kg/m<sup>2</sup>. Mean systolic and diastolic blood pressure at baseline were 127.8 ± 16.3 mmHg and 80.4 ± 11.6, respectively. Baseline static retinal vessel diameter parameters for either arteriolar (CRAE) or venular (CRVE) diameter were in the range of age-related normative values (mean CRAE 174 ± 27µm, normal: 196 ± 13 to 166 ± 17 μm; mean CRVE 225 ± 24µm, normal: 220 ± 15 to 199 ± 16 μm). Parameters of dynamic vessel analysis indicated endothelial dysfunction. Flicker-induced maximal arteriolar (aFID) and venular (vFID) dilatation were reduced compared to age-related normative values (aFID 1.27 ± 1.88%, normal: 3.74 ± 2.17 to 3.79 ± 2.43% and vFID 1.64 ± 2.48%, normal: 4.64 ± 1.85 to 3.86 ± 1.56%). Endothelial function improved significantly after three months compared to baseline (aFID 3.07 ± 2.50, p=0.001; vFID 4.82 ± 1.67, p&lt;0.001), while static vessel diameter parameters remained stable. There was no correlation between static (CRAE, CRVE) or dynamic (aFID, vFID) endothelial function with severity of infection (NIAID-OS score) at baseline or follow-up. <strong>Conclusions:</strong> This study indicates severe endothelial dysfunction at retinal vessels in patients with acute severe COVID-19 with no relation to disease severity. Three months post-infection flicker induced endothelial reaction recovered. <strong>Disclosures</strong>: The authors declare that there is no conflict of interest.