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The punitive symptoms of the long COVID are largely invisible to the naked eye, but new research suggests one of the hallmarks of the disease could literally be staring us in the face.
Long COVID refers to a staggering range of debilitating symptoms that up to 30 percent of patients endure long after recovering from acute SARS-CoV-2 infection, including brain fog, headaches , fatigue, loss of taste and / or smell, and more.
Many of these discomforts are not always evident on the outside, but according to a new study, the long COVID could in fact be detectable in the eyes of patients, in the form of visible nerve damage in the cornea.
The cornea is a transparent dome that forms the front surface of the eye, covering the iris and pupil.
Nerve damage to the cornea can be detected by a non-invasive laser technique called corneal confocal microscopy (CCM), which has been used by researchers to identify corneal abnormalities related to various diseases, such as nerve damage from diabetes, to multiple sclerosis, and fibromyalgia.
Here, the team used the same technique to see if the CCM could identify corneal nerve damage and increased dendritic cells (DC, a type of cell in the immune system) in long-lasting COVID. They compared the results of 40 patients with previous COVID-19 infections with CCM observations of 30 healthy individuals who never had the disease.
According to the researchers, CCM can be used to help indicate a long COVID, with corneal scans from a subset of the COVID-19 group (patients who have reported persistent neurological symptoms after recovery from the virus) showing more great deterioration and loss of corneal nerve fibers, as well as with a higher number of dendritic cells than healthy participants.
“To the best of our knowledge, this is the first study to report corneal nerve loss and increased DC density in patients who have recovered from COVID-19, particularly in subjects with persistent symptoms. compatible with a long COVID, “the researchers, led by first author Gulfidan Bitirgen from Necmettin Erbakan University in Turkey, write in their article.
While this is only a small study – and an observational study, which cannot confirm that COVID-19 actually caused corneal abnormalities in these patients – the links here are evidence nonetheless. further on how SARS-CoV-2 infection may contribute to neurological and neuropathic problems.
This could be due to potential disruptions in the healthy development of nerve fibers, leading to an increase in dendritic cells invoked as part of our immune response.
“These results are consistent with an innate immune and inflammatory process characterized by the migration and accumulation of CD in the central cornea under a number of inflammatory and immune-mediated conditions,” the team explains.
“Further study of the relative change in density of mature and immature DCs and corneal nerves in COVID-19 patients over time may provide information on the contribution of immune and inflammatory pathways to nerve degeneration. “
According to the results, patients with more severe cases of COVID-19 tended to have greater corneal nerve damage, so it is possible that the eye abnormalities presented here all stem from the way the disease presents in the patients, suggest the researchers.
As the team acknowledges, more research with much larger cohorts is needed to pursue these early leads, but for now, this is yet another example of how eye health is closely linked to our health. in the broad sense, this is why techniques like CCM could hold great promise for the future. diagnostic AIDS.
“Corneal confocal microscopy may have clinical utility as a rapid objective ophthalmic test to assess patients with long COVID,” say the researchers.
The results are reported in British Journal of Ophthalmology.
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