ArticleFrontiers in medicine2026
Impact of COVID-19 on corneal endothelial density and morphology: a cross-sectional study in convalescent patients.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Aim: This study aimed to investigate the effect of COVID-19 infection on corneal endothelial cell density and morphology, and to analyze the related factors. Methods: This cross-sectional study included patients who underwent corneal endothelial examination at our institute from August 2022 to May 2023. Patients were categorized into COVID-19 recovery group and non-COVID-19-infection group according to their SARS-CoV-2 infection history. Endothelial cell density (ECD), s tandard deviation of cell area (SD-Area), average cell area (ACA), and hexagonal cell percentage (HEX), among others, were compared between the two groups. To account for confounding factors, univariate analysis assessed the relationship between COVID-19 infection, demographics, medical history, and corneal endothelial cell characteristics. Subsequently, multiple linear regression pinpointed independent factors linked to cell density and morphology. Results: Three hundred seventy-eight patients recovering from COVID-19 and 382 individuals without a history of COVID-19 infection were included in the study. Analysis of corneal endothelial parameters demonstrated a statistically significant decrease in ECD ( Conclusion: A history of COVID-19 infection was found to be significantly associated with decreased corneal endothelial cell density and altered morphology in convalescent patients. While these findings suggest potential long-term ocular surface implications, further prospective studies with pre-infection baselines are warranted to establish causality and to define specific, evidence-based guidelines for perioperative corneal endothelial protection in this population.
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