Corneal nerve fibre loss and increased dendritic cells obser
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This study has quantified corneal sub-basal nerve plexus morphology and dendritic cell (DC) density in patients with and without long COVID. Long COVID is characterised by a range of potentially debilitating symptoms which develop in at least 10% of people who have recovered from acute SARS-CoV-2 infection.

40 subjects who had recovered from COVID-19 and 30 control participants were included in this cross-sectional comparative study. All patients underwent assessment with the National Institute for Health and Care Excellence (NICE) long COVID, Douleur Neuropathique 4 (DN4) and Fibromyalgia questionnaires, and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), corneal nerve fibre length (CNFL), and total, mature and immature DC density.

--The mean time after the diagnosis of COVID-19 was 3.7±1.5 months.

--Patients with neurological symptoms 4 weeks after acute COVID-19 had a lower CNFD, CNBD, and CNFL, and increased DC density compared with controls, while patients without neurological symptoms had comparable corneal nerve parameters, but increased DC density.

--There were significant correlations between the total score on the NICE long COVID questionnaire at 4 and 12 weeks with CNFD and CNFL.

Finally, corneal confocal imaging reveals corneal small nerve fibre loss and increased DCs in patients with protracted COVID, particularly those with neurological symptoms. Patients with a lengthy COVID could be objectively identified using CCM.