tetano
Editor, Senior Moderator
Microvasc Res
. 2025 Feb 15:104796.
doi: 10.1016/j.mvr.2025.104796. Online ahead of print. Imaging the microvasculature using nailfold capillaroscopy in patients with coronavirus disease-2019; A cross-sectional study
S Wilkinson[SUP] 1 [/SUP], J Wilkinson[SUP] 2 [/SUP], A Grace[SUP] 3 [/SUP], D Lyon[SUP] 3 [/SUP], M Mellor[SUP] 3 [/SUP], T Yunus[SUP] 3 [/SUP], J Manning[SUP] 1 [/SUP], G Dinsdale[SUP] 1 [/SUP], M Berks[SUP] 4 [/SUP], S Knight[SUP] 5 [/SUP], N Bakerly[SUP] 6 [/SUP], A Gebril[SUP] 3 [/SUP], P Dark[SUP] 7 [/SUP], A Herrick[SUP] 1 [/SUP], C Taylor[SUP] 8 [/SUP], M Dickinson[SUP] 9 [/SUP], A Murray[SUP] 10 [/SUP]
Affiliations
Objectives: It is understood that microvascular dysfunction plays a key role in the pathogenesis of SARS-CoV-2 coronavirus disease (COVID-19). The aim of this study was to evaluate the usefulness of an automated, quantitative nailfold capillaroscopy system in identifying microvascular changes in those confirmed with or having had COVID-19.
Methods: Ninety-seven participants were enrolled into this study and grouped as follows: 52 participants with acute COVID-19 (further grouped by disease severity) and 45 participants with convalescent COVID-19 (further grouped into long COVID i.e. symptoms beyond 12 weeks, and fully recovered). Nailfold capillaroscopy images were obtained from the bilateral ring fingers using a Dino-Lite CapillaryScope 200 Pro, a small USB handheld microscope. Images were assessed quantitatively using bespoke automated measurement software and the number of haemorrhages noted for each participant.
Results: Capillaries were predominantly 'normal' in appearance with narrow capillary loops and evenly distributed, but with an increased number of haemorrhages (40 % in the convalescent group and 17 % in the acute group, p = 0.007). There was no statistically significant difference in the mean width of capillaries (20.9-21.8 μm) or vessel density (9.6-9.9 caps/mm; acute and convalescent group, respectively).
Conclusions: This study has demonstrated the feasibility of nailfold capillaroscopy at the critical care bedside. Capillary structure appeared normal across all groups of individuals affected by COVID-19. Although the small differences in the microvasculature in recovered patients compared to in acutely unwell patients may suggest delayed structural change due to COVID-19, these differences are unlikely to be clinically relevant. Longitudinal studies would be required to explore this in more detail.
Keywords: COVID-19; Haemorrhage; Microvasculature; Nailfold capillaroscopy; Non-invasive imaging.
. 2025 Feb 15:104796.
doi: 10.1016/j.mvr.2025.104796. Online ahead of print. Imaging the microvasculature using nailfold capillaroscopy in patients with coronavirus disease-2019; A cross-sectional study
S Wilkinson[SUP] 1 [/SUP], J Wilkinson[SUP] 2 [/SUP], A Grace[SUP] 3 [/SUP], D Lyon[SUP] 3 [/SUP], M Mellor[SUP] 3 [/SUP], T Yunus[SUP] 3 [/SUP], J Manning[SUP] 1 [/SUP], G Dinsdale[SUP] 1 [/SUP], M Berks[SUP] 4 [/SUP], S Knight[SUP] 5 [/SUP], N Bakerly[SUP] 6 [/SUP], A Gebril[SUP] 3 [/SUP], P Dark[SUP] 7 [/SUP], A Herrick[SUP] 1 [/SUP], C Taylor[SUP] 8 [/SUP], M Dickinson[SUP] 9 [/SUP], A Murray[SUP] 10 [/SUP]
Affiliations
- PMID: 39961398
- DOI: 10.1016/j.mvr.2025.104796
Objectives: It is understood that microvascular dysfunction plays a key role in the pathogenesis of SARS-CoV-2 coronavirus disease (COVID-19). The aim of this study was to evaluate the usefulness of an automated, quantitative nailfold capillaroscopy system in identifying microvascular changes in those confirmed with or having had COVID-19.
Methods: Ninety-seven participants were enrolled into this study and grouped as follows: 52 participants with acute COVID-19 (further grouped by disease severity) and 45 participants with convalescent COVID-19 (further grouped into long COVID i.e. symptoms beyond 12 weeks, and fully recovered). Nailfold capillaroscopy images were obtained from the bilateral ring fingers using a Dino-Lite CapillaryScope 200 Pro, a small USB handheld microscope. Images were assessed quantitatively using bespoke automated measurement software and the number of haemorrhages noted for each participant.
Results: Capillaries were predominantly 'normal' in appearance with narrow capillary loops and evenly distributed, but with an increased number of haemorrhages (40 % in the convalescent group and 17 % in the acute group, p = 0.007). There was no statistically significant difference in the mean width of capillaries (20.9-21.8 μm) or vessel density (9.6-9.9 caps/mm; acute and convalescent group, respectively).
Conclusions: This study has demonstrated the feasibility of nailfold capillaroscopy at the critical care bedside. Capillary structure appeared normal across all groups of individuals affected by COVID-19. Although the small differences in the microvasculature in recovered patients compared to in acutely unwell patients may suggest delayed structural change due to COVID-19, these differences are unlikely to be clinically relevant. Longitudinal studies would be required to explore this in more detail.
Keywords: COVID-19; Haemorrhage; Microvasculature; Nailfold capillaroscopy; Non-invasive imaging.