Department of Obstetrics and Gynecology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Obstetrics and Gynecology, First People's Hospital of Chenzhou, Chenzhou, China.
Front Immunol. 2024 Jul 16;15:1440262. doi: 10.3389/fimmu.2024.1440262. eCollection 2024.
To investigate the potential causal association between COVID-19 exposure and optic nerve and visual pathway disorders through a two-sample bidirectional Mendelian randomization (MR) analysis, and to provide empirical support for the lung-brain axis.
This MR analysis utilized publicly accessible summary-level data from genome-wide association studies on COVID-19 (n=158,783) and optic nerve and visual pathway diseases (n=412,181), primarily involving individuals of European descent. The random-effect inverse-variance weighted estimation was applied as the main analytical approach, complemented by MR-Egger, weighted median, and weighted mode methods. The heterogeneity and pleiotropy of the instrumental variables were assessed using Cochran's Q test, leave-one-out sensitivity analysis, MR-Egger intercept test, MR-PRESSO, and funnel plot evaluations.
In the forward analysis, the inverse-variance weighted method identified a significant causal effect of COVID-19 on optic nerve and visual pathway disorders (odds ratio = 1.697, 95% confidence interval: 1.086-2.652, = 0.020). Directionally consistent results were also observed with MR-Egger regression, weighted median, and weighted mode approaches. Conversely, the reverse analysis revealed no causal effects of optic nerve and visual pathway disorders on COVID-19 susceptibility.
Our findings suggest that COVID-19 exposure may increase the risk of developing optic nerve and visual pathway disorders, supporting the lung-brain axis hypothesis. These results underscore the importance of vigilant monitoring of the visual system in patients recovering from COVID-19 and suggest potential avenues for future therapeutic strategies.
通过两样本双向孟德尔随机化（MR）分析，研究 COVID-19 暴露与视神经和视觉通路疾病之间的潜在因果关联，并为肺脑轴假说提供经验支持。
本 MR 分析利用了 COVID-19（n=158783）和视神经和视觉通路疾病（n=412181）的全基因组关联研究的公开可用汇总水平数据，主要涉及欧洲血统的个体。随机效应逆方差加权估计作为主要分析方法，辅以 MR-Egger、加权中位数和加权模式方法。使用 Cochran's Q 检验、单样本敏感性分析、MR-Egger 截距检验、MR-PRESSO 和漏斗图评估来评估工具变量的异质性和多效性。
在正向分析中，逆方差加权法发现 COVID-19 对视神经和视觉通路疾病有显著的因果影响（优势比=1.697，95%置信区间：1.086-2.652，p=0.020）。MR-Egger 回归、加权中位数和加权模式方法也观察到了方向一致的结果。相反，反向分析显示视神经和视觉通路疾病对 COVID-19 易感性没有因果影响。
我们的发现表明，COVID-19 暴露可能增加视神经和视觉通路疾病的发病风险，支持肺脑轴假说。这些结果强调了在 COVID-19 康复患者中警惕监测视觉系统的重要性，并为未来的治疗策略提供了潜在途径。
