新冠病毒肺炎双侧肺炎患者中血氧饱和度降低、D-二聚体和白细胞介素6水平升高对血管密度和黄斑无血管区的影响

Effect of reduced saturation and elevated D-dimer and interleukin 6 levels on vessel density and foveal avascular zone in patients with COVID-19 bilateral pneumonia.

作者信息

Kal Magdalena, Brzdęk Michał, Cieśla Elżbieta, Rzymski Piotr, Karska-Basta Izabella, Pinna Antonio, Mackiewicz Jerzy, Winiarczyk Mateusz, Odrobina Dominik, Zarębska-Michaluk Dorota

机构信息

Collegium Medicum of Jan Kochanowski University in Kielce, Poland.

Ophthalmic Clinic of the Voivodeship Hospital in Kielce, Poland.

出版信息

Adv Clin Exp Med. 2025 Aug;34(8):1331-1342. doi: 10.17219/acem/191774.

DOI:10.17219/acem/191774

PMID:39508210

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can affect multiple organs, including the eyes.

OBJECTIVES

This study aimed to identify associations between vascular density (VD) and the foveal avascular zone (FAZ), assessed using optical coherence tomography angiography (OCTA), and baseline levels of D-dimers and interleukin 6 (IL-6) in patients with bilateral COVID-19 pneumonia, depending on oxygen saturation (SpO2) on admission.

MATERIAL AND METHODS

The study included patients with COVID-19 bilateral pneumonia due to SARS-CoV-2 infection who were hospitalized between March and May 2021. Ophthalmological examination was performed 2 months after hospitalization. Optical coherence tomography angiography was used for the automatic assessment of the central retinal VD and the manual assessment of FAZ.

RESULTS

A significant monotonic negative relationship was observed between SpO2 . 90% and VD in some areas of the superficial capillary plexus (SCP) (p = 0.048) and choriocapillaris (p = 0.021), and the mean VD in the deep capillary plexus (DCP) (p = 0.048). No significant monotonic negative relationship was noted between SpO2 . 90% and the FAZ in the SCP (p = 0.075). However, there was a significant monotonic positive relationship between VD in the nasal choriocapillaris and D-dimer levels in patients with SpO2 . 90% (p = 0.003, respectively). Finally, a monotonic negative relationship was identified between foveal VD in the DCP and IL-6 levels in patients with SpO2 . 90% (p = 0.027).

CONCLUSIONS

An OCTA study conducted 2 months after hospitalization for COVID-19 bilateral pneumonia showed reduced VD in those with SpO2 . 90% and elevated levels of D-dimers and IL-6 during hospitalization. Optical coherence tomography angiography testing can provide monitoring of ocular status in patients following SARS-CoV-2 infection, especially those who report visual disturbances.

摘要

背景

严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可累及多个器官，包括眼睛。

目的

本研究旨在确定使用光学相干断层扫描血管造影（OCTA）评估的血管密度（VD）和黄斑无血管区（FAZ）与双侧新冠肺炎肺炎患者D-二聚体和白细胞介素6（IL-6）基线水平之间的关联，具体取决于入院时的血氧饱和度（SpO2）。

材料与方法

本研究纳入了2021年3月至5月因SARS-CoV-2感染而住院的新冠肺炎双侧肺炎患者。在住院2个月后进行眼科检查。光学相干断层扫描血管造影用于自动评估视网膜中央VD和手动评估FAZ。

结果

观察到SpO2＜90%与浅表毛细血管丛（SCP）某些区域的VD（p = 0.048）和脉络膜毛细血管（p = 0.021）以及深层毛细血管丛（DCP）的平均VD（p = 0.048）之间存在显著的单调负相关。未观察到SpO2＜90%与SCP中FAZ之间存在显著的单调负相关（p = 0.075）。然而，SpO2＜90%的患者鼻侧脉络膜毛细血管中的VD与D-二聚体水平之间存在显著的单调正相关（p = 0.003）。最后，在SpO2＜90%的患者中，DCP中的黄斑VD与IL-6水平之间存在单调负相关（p = 0.027）。