Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue
Post-COVID-19 syndrome (PCS) is characterized by persisting sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PCS can affect patients with all COVID-19 disease severities. As previous studies have revealed impaired blood flow as a provoking factor triggering...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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MDPI AG
2022-11-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/23/22/13683 |
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| author | Sarah Schlick Marianna Lucio Gerd Wallukat Alexander Bartsch Adam Skornia Jakob Hoffmanns Charlotte Szewczykowski Thora Schröder Franziska Raith Lennart Rogge Felix Heltmann Michael Moritz Lorenz Beitlich Julia Schottenhamml Martin Herrmann Thomas Harrer Marion Ganslmayer Friedrich E. Kruse Robert Lämmer Christian Mardin Bettina Hohberger |
| author_facet | Sarah Schlick Marianna Lucio Gerd Wallukat Alexander Bartsch Adam Skornia Jakob Hoffmanns Charlotte Szewczykowski Thora Schröder Franziska Raith Lennart Rogge Felix Heltmann Michael Moritz Lorenz Beitlich Julia Schottenhamml Martin Herrmann Thomas Harrer Marion Ganslmayer Friedrich E. Kruse Robert Lämmer Christian Mardin Bettina Hohberger |
| author_sort | Sarah Schlick |
| collection | DOAJ |
| description | Post-COVID-19 syndrome (PCS) is characterized by persisting sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PCS can affect patients with all COVID-19 disease severities. As previous studies have revealed impaired blood flow as a provoking factor triggering PCS, it was the aim of the present study to investigate the potential association between self-reported chronic fatigue and retinal microcirculation in patients with PCS, potentially indicating an objective biomarker. A prospective study was performed, including 201 subjects: 173 patients with PCS and 28 controls. Retinal microcirculation was visualized by OCT angiography (OCT-A) and quantified using the Erlangen-Angio-Tool as macula and peripapillary vessel density (VD). Chronic fatigue (CF) was assessed according to the variables of Bell’s score, age and gender. VDs in the superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) were analyzed, considering the repetitions (12 times). Seropositivity for autoantibodies targeting G protein-coupled receptors (GPCR-AAbs) was determined by an established cardiomyocyte bioassay. Taking account of the repetitions, a mixed model was performed to detect possible differences in the least square means between the different groups included in the analysis. An age effect in relation to VD was observed between patients and controls (<i>p</i> < 0.0001). Gender analysis showed that women with PCS showed lower VD levels in the SVP compared to male patients (<i>p</i> = 0.0015). The PCS patients showed significantly lower VDs in the ICP as compared to the controls (<i>p</i> = 0.0001 (CI: 0.32; 1)). Moreover, considering PCS patients, the mixed model revealed a significant difference between those with chronic fatigue (CF) and those without CF with respect to VDs in the SVP (<i>p</i> = 0.0033 (CI: −4.5; −0.92)). The model included variables of age, gender and Bell’s score, representing a subjective marker for CF. Consequently, retinal microcirculation might serve as an objective biomarker in subjectively reported chronic fatigue in patients with PCS. |
| first_indexed | 2024-03-09T18:18:28Z |
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| language | English |
| last_indexed | 2024-03-09T18:18:28Z |
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| spelling | doaj.art-4795e28a82f34483be2111a44aef182b2023-11-24T08:31:56ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-11-0123221368310.3390/ijms232213683Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic FatigueSarah Schlick0Marianna Lucio1Gerd Wallukat2Alexander Bartsch3Adam Skornia4Jakob Hoffmanns5Charlotte Szewczykowski6Thora Schröder7Franziska Raith8Lennart Rogge9Felix Heltmann10Michael Moritz11Lorenz Beitlich12Julia Schottenhamml13Martin Herrmann14Thomas Harrer15Marion Ganslmayer16Friedrich E. Kruse17Robert Lämmer18Christian Mardin19Bettina Hohberger20Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyResearch Unit Analytical BioGeoChemistry, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764 Neuherberg, GermanyBerlin Cures GmbH, 10719 Berlin, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Internal Medicine 1, Universität of Erlangen-Nürnberg, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, GermanyPost-COVID-19 syndrome (PCS) is characterized by persisting sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PCS can affect patients with all COVID-19 disease severities. As previous studies have revealed impaired blood flow as a provoking factor triggering PCS, it was the aim of the present study to investigate the potential association between self-reported chronic fatigue and retinal microcirculation in patients with PCS, potentially indicating an objective biomarker. A prospective study was performed, including 201 subjects: 173 patients with PCS and 28 controls. Retinal microcirculation was visualized by OCT angiography (OCT-A) and quantified using the Erlangen-Angio-Tool as macula and peripapillary vessel density (VD). Chronic fatigue (CF) was assessed according to the variables of Bell’s score, age and gender. VDs in the superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) were analyzed, considering the repetitions (12 times). Seropositivity for autoantibodies targeting G protein-coupled receptors (GPCR-AAbs) was determined by an established cardiomyocyte bioassay. Taking account of the repetitions, a mixed model was performed to detect possible differences in the least square means between the different groups included in the analysis. An age effect in relation to VD was observed between patients and controls (<i>p</i> < 0.0001). Gender analysis showed that women with PCS showed lower VD levels in the SVP compared to male patients (<i>p</i> = 0.0015). The PCS patients showed significantly lower VDs in the ICP as compared to the controls (<i>p</i> = 0.0001 (CI: 0.32; 1)). Moreover, considering PCS patients, the mixed model revealed a significant difference between those with chronic fatigue (CF) and those without CF with respect to VDs in the SVP (<i>p</i> = 0.0033 (CI: −4.5; −0.92)). The model included variables of age, gender and Bell’s score, representing a subjective marker for CF. Consequently, retinal microcirculation might serve as an objective biomarker in subjectively reported chronic fatigue in patients with PCS.https://www.mdpi.com/1422-0067/23/22/13683retinal microcirculationpost-COVID-19 syndromechronic fatiguefunctional GPCR autoantibodiesCOVID-19long COVID syndrome |
| spellingShingle | Sarah Schlick Marianna Lucio Gerd Wallukat Alexander Bartsch Adam Skornia Jakob Hoffmanns Charlotte Szewczykowski Thora Schröder Franziska Raith Lennart Rogge Felix Heltmann Michael Moritz Lorenz Beitlich Julia Schottenhamml Martin Herrmann Thomas Harrer Marion Ganslmayer Friedrich E. Kruse Robert Lämmer Christian Mardin Bettina Hohberger Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue International Journal of Molecular Sciences retinal microcirculation post-COVID-19 syndrome chronic fatigue functional GPCR autoantibodies COVID-19 long COVID syndrome |
| title | Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue |
| title_full | Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue |
| title_fullStr | Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue |
| title_full_unstemmed | Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue |
| title_short | Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue |
| title_sort | post covid 19 syndrome retinal microcirculation as a potential marker for chronic fatigue |
| topic | retinal microcirculation post-COVID-19 syndrome chronic fatigue functional GPCR autoantibodies COVID-19 long COVID syndrome |
| url | https://www.mdpi.com/1422-0067/23/22/13683 |
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