The Impact of Severe COVID–19 on Corneal Endothelial Cells–Analysis of the In Vivo Noncontact Specular Microscopy.

Purpose: This study aimed to investigate the effects of severe COVID-19 infection on the corneal endothelium via in vivo specular microscopy. Methods: This was an observational, prospective, and controlled study including 56 eyes of 56 severe COVID-19 patients, compared to after-recovery and 56 eyes of 56 age- and gender-matched healthy controls. Results: Endothelial cell density was lower in the active disease period compared to healthy controls (p =.001) and decreased even more after recovery (p <.0001). After recovery, the average cell area and coefficient of variation were higher compared to the active disease period (p <.0001 and p =.008, respectively) and the healthy controls (for both, p <.0001), whereas hexagonality was lower (p <.0001). Central corneal thickness increased in the active disease period compared to after recovery (p <.0001) and healthy controls (p =.002). Conclusions: These results may be due to direct host-virus interaction or linked to immune dysregulation, subclinical corneal endotheliitis, or still yet a viral-mediated inflammation. [ABSTRACT FROM AUTHOR]