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.

Abstract

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