Assessing the Role of SerpinA3 in Diabetic Retinopathy, COVID-19 Infection and Associated Clinical Outcomes

Abstract

Purpose : Studies have shown that diabetic patients may have a higher risk for developing complications related to COVID-19 infection, however, the specific effect of COVID-19 infection on patients with diabetic retinopathy (DR) is not clear. The objective of this study was to discover the associations between DR, severity of COVID-19 infection and the levels of serum SerpinA3, an inflammatory protease that has been implicated in the pathogenesis of DR and COVID-19.

Methods : Blood samples were collected from human subjects and history of COVID-19 infection was first determined by measuring SARS-CoV-2 IgG antibodies using ELISA assays. A total of 40 demographically matched diabetic subjects were selected with a history of previous COVID-19 infection (20 with DR and 20 without DR). The electronic medical records were retrospectively evaluated to determine DR status, COVID-19 infection and clinical outcomes. Serum SerpinA3 levels were measured, and statistical analyses were performed to discover their associations with DR and clinical outcomes, such as hospitalizations and length of hospitalization.

Results : Higher HbA1c levels were associated with higher SerpinA3 levels (p=0.0234), supporting the role of this protease in the pathogenesis of diabetes. The serum SerpinA3 levels were highest in the patients with DR and a history of COVID-19 infection. Medical records indicated that 40% of DR patients who were infected with COVID-19 were hospitalized while none of the COVID-19 positive patients without DR were hospitalized. Finally, there were significantly higher SerpinA3 levels in patients with COVID19 hospitalization as compared to those without hospitalization (p=0.013).

Conclusions : Higher SerpinA3 levels are associated with DR and history of COVID-19 infection. Also, the DR patients with COVID-19 infection face more severe clinical outcomes as compared to patients without DR.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.