loading page

Unveiling the Metabolic and Coagulation Disruptions in SARS-CoV-2-Associated Acute Macular Neuroretinopathy: A Case-control Study
  • +6
  • Minming Zheng,
  • Xiaojing Xiong,
  • Zheng Zheng,
  • Chunlin Liu,
  • Xinyu Wang,
  • Shuai Luo,
  • Qinqin Xie,
  • Yang Liu,
  • Qingwei Chen
Minming Zheng
The Second Affiliated Hospital of Chongqing Medical University

Corresponding Author:304239@hospital.cqmu.edu.cn

Author Profile
Xiaojing Xiong
The Second Affiliated Hospital of Chongqing Medical University
Author Profile
Zheng Zheng
The Second Affiliated Hospital of Chongqing Medical University
Author Profile
Chunlin Liu
The Second Affiliated Hospital of Chongqing Medical University
Author Profile
Xinyu Wang
The Second Affiliated Hospital of Chongqing Medical University
Author Profile
Shuai Luo
The Second Affiliated Hospital of Chongqing Medical University
Author Profile
Qinqin Xie
The Second Affiliated Hospital of Chongqing Medical University
Author Profile
Yang Liu
The Second Affiliated Hospital of Chongqing Medical University
Author Profile
Qingwei Chen
The Second Affiliated Hospital of Chongqing Medical University
Author Profile

Abstract

Background: SARS-CoV-2 infection has been associated with the increased incidence of acute macular neuroretinopathy (AMN), an infrequent ocular disorder. However, the precise mechanisms underpinning AMN in the context of SARS-CoV-2 infection (AMN-SARS-CoV-2) remain elusive. Methods: In this case-control study 14 patients diagnosed with AMN-SARS-CoV-2 between 2022/12 and 2023/3 were enrolled in this study. 14 SARS-CoV-2-infected individuals without AMN (SARS-CoV-2-no AMN) as control. 14 AMN-SARS-CoV-2 patients were compared with 14 SARS-CoV-2-no AMN. Metabolomic profiling using Ultra-High-Performance Liquid Chromatography-Online Electrospray Mass Spectrometry (UHPLC-OE-MS) revealed significant alterations in serum metabolites in AMN-SARS-CoV-2 patients. Abnormal blood clotting was observed in AMN-SARS-CoV-2 patients, and its relationship with metabolic disorders was studied. Finally, a predictive model for AMN-SARS-CoV-2 was established. Results: 76 upregulated and 42 downregulated metabolites were discovered in AMN-SARS-CoV-2. Notably, arginine metabolism within the urea cycle showed substantial changes, evidenced by variations in ornithine, citrulline, L-proline, and ADAM levels, correlating with abnormal coagulation markers like platelet crit (PCT), fibrinogen degradation products (FDP), and fibrinogen (Fbg). Additionally, increased arginase 1 (AGR1) activity within the urea cycle and reduced nitric oxide synthase (NOS) activity were observed in AMN-SARS-CoV-2. Combining these urea cycle metabolites with coagulation parameters effectively distinguished AMN-SARS-CoV-2 from SARS-CoV-2-no AMN, with an area under the curve (AUC) value of 0.96. Conclusion: The findings of the present study enhance our comprehension of the underlying metabolic mechanisms associated with AMN-SARS-CoV-2 and offer potential diagnostic markers for this uncommon ocular disorder within the context of SARS-CoV-2 infection.
Submitted to Journal of Medical Virology
28 Jan 2024Review(s) Completed, Editorial Evaluation Pending
04 Mar 2024Editorial Decision: Revise Major
18 Mar 20241st Revision Received
21 Mar 2024Submission Checks Completed
21 Mar 2024Assigned to Editor
21 Mar 2024Review(s) Completed, Editorial Evaluation Pending
23 Apr 2024Reviewer(s) Assigned