tetano
Editor, Senior Moderator
Angiogenesis
. 2022 Aug 11.
doi: 10.1007/s10456-022-09850-9. Online ahead of print.
Persistent capillary rarefication in long COVID syndrome
Irina Osiaevi[SUP] 1 [/SUP], Arik Schulze[SUP] 1 [/SUP], Georg Evers[SUP] 1 [/SUP], Kimon Harmening[SUP] 1 [/SUP], Hans Vink[SUP] 2 [/SUP], Philipp Kümpers[SUP] 3 [/SUP], Michael Mohr[SUP] #[/SUP][SUP] 1 [/SUP], Alexandros Rovas[SUP] #[/SUP][SUP] 4 [/SUP]
Affiliations
Abstract
Background: Recent studies have highlighted Coronavirus disease 2019 (COVID-19) as a multisystemic vascular disease. Up to 60% of the patients suffer from long-term sequelae and persistent symptoms even 6 months after the initial infection.
Methods: This prospective, observational study included 58 participants, 27 of whom were long COVID patients with persistent symptoms > 12 weeks after recovery from PCR-confirmed SARS-CoV-2 infection. Fifteen healthy volunteers and a historical cohort of critically ill COVID-19 patients (n = 16) served as controls. All participants underwent sublingual videomicroscopy using sidestream dark field imaging. A newly developed version of Glycocheck™ software was used to quantify vascular density, perfused boundary region (PBR-an inverse variable of endothelial glycocalyx dimensions), red blood cell velocity (VRBC) and the microvascular health score (MVHS™) in sublingual microvessels with diameters 4-25 µm.
Measurements and main results: Although dimensions of the glycocalyx were comparable to those of healthy controls, a µm-precise analysis showed a significant decrease of vascular density, that exclusively affected very small capillaries (D5: - 45.16%; D6: - 35.60%; D7: - 22.79%). Plotting VRBC of capillaries and feed vessels showed that the number of capillaries perfused in long COVID patients was comparable to that of critically ill COVID-19 patients and did not respond adequately to local variations of tissue metabolic demand. MVHS was markedly reduced in the long COVID cohort (healthy 3.87 vs. long COVID 2.72 points; p = 0.002).
Conclusions: Our current data strongly suggest that COVID-19 leaves a persistent capillary rarefication even 18 months after infection. Whether, to what extent, and when the observed damage might be reversible remains unclear.
Keywords: COVID-19; Endothelial glycocalyx; Endotheliopathy; Long COVID microcirculation; Microvascular health score; Sublingual microscopy.
. 2022 Aug 11.
doi: 10.1007/s10456-022-09850-9. Online ahead of print.
Persistent capillary rarefication in long COVID syndrome
Irina Osiaevi[SUP] 1 [/SUP], Arik Schulze[SUP] 1 [/SUP], Georg Evers[SUP] 1 [/SUP], Kimon Harmening[SUP] 1 [/SUP], Hans Vink[SUP] 2 [/SUP], Philipp Kümpers[SUP] 3 [/SUP], Michael Mohr[SUP] #[/SUP][SUP] 1 [/SUP], Alexandros Rovas[SUP] #[/SUP][SUP] 4 [/SUP]
Affiliations
- PMID: 35951203
- DOI: 10.1007/s10456-022-09850-9
Abstract
Background: Recent studies have highlighted Coronavirus disease 2019 (COVID-19) as a multisystemic vascular disease. Up to 60% of the patients suffer from long-term sequelae and persistent symptoms even 6 months after the initial infection.
Methods: This prospective, observational study included 58 participants, 27 of whom were long COVID patients with persistent symptoms > 12 weeks after recovery from PCR-confirmed SARS-CoV-2 infection. Fifteen healthy volunteers and a historical cohort of critically ill COVID-19 patients (n = 16) served as controls. All participants underwent sublingual videomicroscopy using sidestream dark field imaging. A newly developed version of Glycocheck™ software was used to quantify vascular density, perfused boundary region (PBR-an inverse variable of endothelial glycocalyx dimensions), red blood cell velocity (VRBC) and the microvascular health score (MVHS™) in sublingual microvessels with diameters 4-25 µm.
Measurements and main results: Although dimensions of the glycocalyx were comparable to those of healthy controls, a µm-precise analysis showed a significant decrease of vascular density, that exclusively affected very small capillaries (D5: - 45.16%; D6: - 35.60%; D7: - 22.79%). Plotting VRBC of capillaries and feed vessels showed that the number of capillaries perfused in long COVID patients was comparable to that of critically ill COVID-19 patients and did not respond adequately to local variations of tissue metabolic demand. MVHS was markedly reduced in the long COVID cohort (healthy 3.87 vs. long COVID 2.72 points; p = 0.002).
Conclusions: Our current data strongly suggest that COVID-19 leaves a persistent capillary rarefication even 18 months after infection. Whether, to what extent, and when the observed damage might be reversible remains unclear.
Keywords: COVID-19; Endothelial glycocalyx; Endotheliopathy; Long COVID microcirculation; Microvascular health score; Sublingual microscopy.