Cañadas Pilar, Gonzalez-Vides Leonela, Alberquilla García-Velasco Marta, Arriola Pedro, Guemes-Villahoz Noemí, Hernández-Verdejo Jose Luis
Optometry and Vision Department, School of Optometry, Complutense University of Madrid, 28037 Madrid, Spain.
Education Faculty, University of Costa Rica, San José 11501-2060, Costa Rica.
Diagnostics (Basel). 2023 Oct 12;13(20):3188. doi: 10.3390/diagnostics13203188.
To describe corneal confocal microscopy findings in patients with long COVID-19 with persistent symptoms over 20 months after SARS-CoV-2 infection.
A descriptive cross-sectional study that included a total of 88 patients; 60 patients with Long COVID-19 and 28 controls. Long COVID-19 diagnosis was established according to the World Health Organization criteria. Corneal confocal microscopy using a Heidelberg Retina Tomograph II (Heidelberg Engineering, Heidelberg, Germany) was performed to evaluate sub-basal nerve plexus morphology (corneal nerve fiber density, nerve fiber length, nerve branch density, nerve fiber total branch density, nerve fiber area, and nerve fiber width). Dendritic cell density and area, along with microneuromas and other morphological changes of the nerve fibers were recorded.
Long COVID-19 patients presented with reduced corneal nerve density and branch density as well as shorter corneal nerves compared to the control group. Additionally, Long COVID-19 patients showed an increased density of dendritic cells also with a greater area than that found in the control group of patients without systemic diseases. Microneuromas were detected in 15% of Long COVID-19 patients.
Long COVID-19 patients exhibited altered corneal nerve parameters and increased DC density over 20 months after acute SARS-CoV-2 infection. These findings are consistent with a neuroinflammatory condition hypothesized to be present in patients with Long COVID-19, highlighting the potential role of corneal confocal microscopy as a promising noninvasive technique for the study of patients with Long COVID-19.
描述新型冠状病毒肺炎（COVID-19）康复后20个月仍有持续症状的患者的角膜共焦显微镜检查结果。
一项描述性横断面研究，共纳入88例患者；60例长期COVID-19患者和28例对照。根据世界卫生组织标准确立长期COVID-19诊断。使用海德堡视网膜断层扫描仪II（德国海德堡海德堡工程公司）进行角膜共焦显微镜检查，以评估基底神经丛形态（角膜神经纤维密度、神经纤维长度、神经分支密度、神经纤维总分支密度、神经纤维面积和神经纤维宽度）。记录树突状细胞密度和面积，以及神经纤维的微神经瘤和其他形态学变化。
与对照组相比，长期COVID-19患者的角膜神经密度和分支密度降低，角膜神经较短。此外，长期COVID-19患者的树突状细胞密度增加，其面积也大于无全身性疾病的对照组患者。在15%的长期COVID-19患者中检测到微神经瘤。
急性SARS-CoV-2感染20个月后，长期COVID-19患者的角膜神经参数改变，树突状细胞密度增加。这些发现与假设存在于长期COVID-19患者中的神经炎症状态一致，突出了角膜共焦显微镜检查作为一种有前景的非侵入性技术在长期COVID-19患者研究中的潜在作用。
