Pupillometry in critically ill patients with COVID-19: a prospective study

Vrettou, Charikleia; Korompoki, Eleni; Sarri, Katerina; Papachatzakis, Ioannis; Θεοδωρακοπούλου, Μαρία; Chrysanthopoulou, Evangelia; Andrianakis, Ilias; Routsi, Christina; Zakynthinos, Spyros; Kotanidou, Anastasia

doi:10.1007/s10286-020-00737-7

Cited by 13 publications

(27 citation statements)

References 10 publications

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“…Indeed, pupil responses assessed with an automatic pupillometer were found impaired in patients recovering from COVID-19 [75]. Although this impairment might be present already during the acute phase in critically ill COVID-19 patients [76], controversial results have been found since ANS responses might be attenuated in the intensive care unit (ICU) population by ICU-related interventions, such as the administration of anesthetics, analgesics and inotropic medications that may have a prolonged effect [77]. In our sample, about one-half of the participants reported ocular impairments, and light sensitivity was the most common complaint.…”

Section: Discussionmentioning

confidence: 99%

Autonomic dysfunction in post-COVID patients with and witfhout neurological symptoms: a prospective multidomain observational study

et al. 2021

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The autonomic nervous system (ANS) can be affected by COVID-19, and dysautonomia may be a possible complication in post-COVID individuals. Orthostatic hypotension (OH) and postural tachycardia syndrome (POTS) have been suggested to be common after SARS-CoV-2 infection, but other components of ANS function may be also impaired. The Composite Autonomic Symptom Scale 31 (COMPASS-31) questionnaire is a simple and validated tool to assess dysautonomic symptoms. The aim of the present study was to administer the COMPASS-31 questionnaire to a sample of post-COVID patients with and without neurological complaints. Participants were recruited among the post-COVID ambulatory services for follow-up evaluation between 4 weeks and 9 months from COVID-19 symptoms onset. Participants were asked to complete the COMPASS-31 questionnaire referring to the period after COVID-19 disease. Heart rate and blood pressure were manually taken during an active stand test for OH and POTS diagnosis. One-hundred and eighty participants were included in the analysis (70.6% females, 51 ± 13 years), and OH was found in 13.8% of the subjects. Median COMPASS-31 score was 17.6 (6.9–31.4), with the most affected domains being orthostatic intolerance, sudomotor, gastrointestinal and pupillomotor dysfunction. A higher COMPASS-31 score was found in those with neurological symptoms (p < 0.01), due to more severe orthostatic intolerance symptoms (p < 0.01), although gastrointestinal (p < 0.01), urinary (p < 0.01), and pupillomotor (p < 0.01) domains were more represented in the non-neurological symptoms group. This study confirms the importance of monitoring ANS symptoms as a possible complication of COVID-19 disease that may persist in the post-acute period.

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Section: Discussionmentioning

confidence: 99%

Autonomic dysfunction in post-COVID patients with and witfhout neurological symptoms: a prospective multidomain observational study

et al. 2021

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“…Abnormalities in accommodation, tonic pupil and the Holmes-Adie syndrome have also been described in people with COVID-19 [ 7 , 24 – 26 ]. Vrettou et al [ 27 ] hypothesized that the increase in pupil size and reduced pupillary light response in patients with COVID-19 may be an acute phenomenon with cytokine activation of the locus coeruleus and inhibitory signaling to the Edinger–Westphal nucleus. However, we now show altered pupillary responses, 4.0 months after acute COVID-19 characterized by a prolonged latency and a shorter duration of pupil contraction indicative of continuing parasympathetic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Abnormal quantitative pupillary light responses following COVID-19

et al. 2022

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“…Despite the many difficulties associated with the global COVID-19 pandemic, the year 2020 was a good one for Clinical Autonomic Research, and the prospects for 2021 are even better. During 2020, the journal published special issues and articles on the autonomic aspects related to COVID-19 [ 2 , 5 , 7 , 10 , 12 , 13 ]. All COVID-19-related manuscripts are Open Access immediately upon publication.…”

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confidence: 99%