key: cord-0851422-sn0751yr
authors: Nourinia, Ramin; Ghassempour, Mehrbod; Ahmadieh, Hamid; Abtahi, Seyed-Hossein
title: Branch Retinal Vein Occlusion after COVID-19
date: 2021-07-08
journal: J Fr Ophtalmol
DOI: 10.1016/j.jfo.2021.06.003
sha: df50de9337db9a822893decb669096e7a005179b
doc_id: 851422
cord_uid: sn0751yr

nan

A 60-years-old woman was admitted to the emergency department of our center for evaluation of pneumonia, severe drowsiness and high fever (39.3 degrees Celsius). Soon after primary workup including lung computed tomography scan and reverse transcriptase polymerase chain reaction analysis for COVID-19, she was hospitalized. Being positive for the tests, she was admitted in intensive care unit with the diagnosis of COVID-19 associated pneumonia and meningoencephalitis. After seven days, respiratory and mental status of the patient recovered and she was transferred to ward for further care. 

This is the first case of BRVO in the context of COVID-19 infection. Coagulation abnormalities and prothrombotic state has been associated with COVID-19 infection [1] . By entry of the viral particles into host's cells, ECA2 and TMPRSS2 get internalized and attenuated. This leads to imbalance of the ACE2/Angiotensin pathway. Vasoconstriction and pronounced inflammation caused by Angiotensin II and endothelial dysfunction caused by ECA2 under-expression leads to a pro-coagulant and pro-adhesive state [1, 2] . Further, hyperinflammatory response and the 'cytokine-storm' lead to a systemic thrombo-inflammatory environment. Systemic thromoboembolic events such as pulmonary thromboembolism and cerebral vascular accidents are well known to occur in COVID-19 patients [1] [2] [3] [4] . In our case, increased levels of inflammatory markers, such as CRP, ferritin and D-dimer support this explanation.

In the first descriptions of COVID-19, its ophthalmic manifestations were mostly limited to the redness of eye, irritation, and conjunctivitis. However, it is becoming clear that retina can also be involved in the process of this disease [5] . In this regard, all should be aware of how these patients are at a higher risk of thromboembolic events such as retinal vein occlusion.

All the authors agreed on this report. Institutional ethical approval was obtained for this manuscript. Also, consent of the patient is provided through the submission process.

None. 

Coagulation abnormalities and thrombosis in patients with COVID-19

COVID-19, ACE2, and the cardiovascular consequences

COVID-19-related severe hypercoagulability in patients admitted to intensive care unit for acute respiratory failure

COVID-19 Related Cerebrovascular Thromboembolic Complications in Three Young Patients

Optical coherence tomography angiography analysis of the retina in patients recovered from COVID-19: a case-control study

The authors have no proprietary interest in the materials presented herein.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

All authors contributed in data collection, medical writing, interpretation of the data, and final review of the draft.