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Reviews of "Histopathological assessments reveal retinal vascular changes, inflammation, and gliosis in patients with lethal COVID-19"

Reviewers: Alessandro Invernizzi (University of Milan) | 📗📗📗📗◻️ • Manuel Landecho (Clinica Universidad de Navarra) | 📗📗📗📗◻️

Published onApr 18, 2021
Reviews of "Histopathological assessments reveal retinal vascular changes, inflammation, and gliosis in patients with lethal COVID-19"
key-enterThis Pub is a Review of
Histopathological assessments reveal retinal vascular changes, inflammation and gliosis in patients with lethal COVID-19
Description

ABSTRACTPurposeTo assess for histopathological changes within the retina and the choroid and determine the long-term sequelae of the SARS-CoV-2 infection.DesignComparative analysis of human eyes.SubjectsEleven donor eyes from COVID-19 positive donors and similar age-matched donor eyes from patients with a negative test for SARS-CoV-2 were assessed.MethodsGlobes were evaluated ex-vivo with macroscopic, SLO and OCT imaging. Macula and peripheral regions were processed for epon-embedding and immunocytochemistryMain Outcome MeasuresRetinal thickness and histopathology, detection of SARS-CoV-2 Spike protein, changes in vascular density, gliosis, and degree of inflammation.ResultsFundus analysis shows hemorrhagic spots and increased vitreous debris in several of the COVID-19 eyes compared to the control. OCT based measurements indicated an increased trend in retinal thickness in the COVID-19 eyes, however the difference was not statistically significant. Histology of the retina showed presence of hemorrhages and central cystoid degeneration in several of the donors. Whole mount analysis of the retina labeled with markers showed changes in retinal microvasculature, increased inflammation, and gliosis in the COVID-19 eyes compared to the controls. The choroidal vasculature displayed localized changes in density and signs of increased inflammation in the COVID-19 samples.ConclusionsIn situ analysis of the retinal tissue suggested that there are severe subclinical abnormalities that could be detected in the COVID-19 eyes. This study provides a rationale for evaluating the ocular physiology of patients that have recovered from COVID-19 infections to further understand the long-term effects caused by this virus.

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Summary of Reviews: This preprint provides an in situ analysis of retinal tissue and suggests that there are severe subclinical abnormalities that could be detected in the eyes of covid-19 positive patients. The relevance of these findings in in-vivo evaluation among COVID-19 patients is needed.

Reviewer 1 (Alessandro Invernizzi) | 📗📗📗📗◻️

Reviewer 2 (Manuel Landecho) | 📗📗📗📗◻️

RR:C19 Strength of Evidence Scale Key

📕 ◻️◻️◻️◻️ = Misleading

📙📙 ◻️◻️◻️ = Not Informative

📒📒📒 ◻️◻️ = Potentially Informative

📗📗📗📗◻️ = Reliable

📘📘📘📘📘 = Strong

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