tetano
Editor, Senior Moderator
Microvasc Res
. 2020 Sep 16;104071.
doi: 10.1016/j.mvr.2020.104071. Online ahead of print.
Nailfold capillaroscopy findings in patients with coronavirus disease 19: Broadening the spectrum of covid-19 microvascular involvement
Gerlando Natalello[SUP] 1 [/SUP], Giacomo De Luca[SUP] 2 [/SUP], Laura Gigante[SUP] 3 [/SUP], Corrado Campochiaro[SUP] 2 [/SUP], Enrico De Lorenzis[SUP] 4 [/SUP], Lucrezia Verardi[SUP] 3 [/SUP], Annamaria Paglionico[SUP] 3 [/SUP], Luca Petricca[SUP] 3 [/SUP], Anna Maria Martone[SUP] 5 [/SUP], Stefania Calvisi[SUP] 6 [/SUP], Marco Ripa[SUP] 7 [/SUP], Giulio Cavalli[SUP] 2 [/SUP], Emanuel Della-Torre[SUP] 2 [/SUP], Moreno Tresoldi[SUP] 6 [/SUP], Francesco Landi[SUP] 5 [/SUP], Silvia Laura Bosello[SUP] 3 [/SUP], Elisa Gremese[SUP] 3 [/SUP], Lorenzo Dagna[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: Increasing evidence points to endothelial dysfunction as a key pathophysiological factor in coronavirus disease-2019 (COVID-19). No specific methods have been identified to predict, detect and quantify the microvascular alterations during COVID-19. Our aim was to assess microvasculature through nailfold videocapillaroscopy (NVC) in COVID-19 patients.
Methods: We performed NVC in patients with a confirmed diagnosis of COVID-19 pneumonia. Elementary alterations were reported for each finger according to a semi-quantitative score. Capillary density, number of enlarged and giant capillaries, number of micro-hemorrhages and micro-thrombosis (NEMO score) were registered.
Results: We enrolled 82 patients (mean age 58.8 ? 13.2 years, male 68.3%) of whom 28 during the hospitalization and 54 after recovery and hospital discharge. At NVC examination we found abnormalities classifiable as non-specific pattern in 53 patients (64.6%). Common abnormalities were pericapillary edema (80.5%), enlarged capillaries (61.0%), sludge flow (53.7%), meandering capillaries and reduced capillary density (50.0%). No pictures suggestive of scleroderma pattern have been observed. Acute COVID-19 patients, compared to recovered patients, showed a higher prevalence of hemosiderin deposits as a result of micro-hemorrhages (P = .027) and micro-thrombosis (P < .016), sludge flow (P = .001), and pericapillary edema (P < .001), while recovered patients showed a higher prevalence of enlarged capillaries (P < .001), loss of capillaries (P = .002), meandering capillaries (P < .001), and empty dermal papillae (P = .006).
Conclusion: COVID-19 patients present microvascular abnormalities at NVC. Currently ill and recovered subjects are characterized by a different distribution of elementary capillaroscopic alterations, resembling acute and post-acute microvascular damage. Further studies are needed to assess the clinical relevance of NVC in COVID-19.
Keywords: COVID-19; Micro-thrombosis; Microangiopathy; Nailfold videocapillaroscopy.
. 2020 Sep 16;104071.
doi: 10.1016/j.mvr.2020.104071. Online ahead of print.
Nailfold capillaroscopy findings in patients with coronavirus disease 19: Broadening the spectrum of covid-19 microvascular involvement
Gerlando Natalello[SUP] 1 [/SUP], Giacomo De Luca[SUP] 2 [/SUP], Laura Gigante[SUP] 3 [/SUP], Corrado Campochiaro[SUP] 2 [/SUP], Enrico De Lorenzis[SUP] 4 [/SUP], Lucrezia Verardi[SUP] 3 [/SUP], Annamaria Paglionico[SUP] 3 [/SUP], Luca Petricca[SUP] 3 [/SUP], Anna Maria Martone[SUP] 5 [/SUP], Stefania Calvisi[SUP] 6 [/SUP], Marco Ripa[SUP] 7 [/SUP], Giulio Cavalli[SUP] 2 [/SUP], Emanuel Della-Torre[SUP] 2 [/SUP], Moreno Tresoldi[SUP] 6 [/SUP], Francesco Landi[SUP] 5 [/SUP], Silvia Laura Bosello[SUP] 3 [/SUP], Elisa Gremese[SUP] 3 [/SUP], Lorenzo Dagna[SUP] 2 [/SUP]
Affiliations
- PMID: 32949574
- DOI: 10.1016/j.mvr.2020.104071
Abstract
Objective: Increasing evidence points to endothelial dysfunction as a key pathophysiological factor in coronavirus disease-2019 (COVID-19). No specific methods have been identified to predict, detect and quantify the microvascular alterations during COVID-19. Our aim was to assess microvasculature through nailfold videocapillaroscopy (NVC) in COVID-19 patients.
Methods: We performed NVC in patients with a confirmed diagnosis of COVID-19 pneumonia. Elementary alterations were reported for each finger according to a semi-quantitative score. Capillary density, number of enlarged and giant capillaries, number of micro-hemorrhages and micro-thrombosis (NEMO score) were registered.
Results: We enrolled 82 patients (mean age 58.8 ? 13.2 years, male 68.3%) of whom 28 during the hospitalization and 54 after recovery and hospital discharge. At NVC examination we found abnormalities classifiable as non-specific pattern in 53 patients (64.6%). Common abnormalities were pericapillary edema (80.5%), enlarged capillaries (61.0%), sludge flow (53.7%), meandering capillaries and reduced capillary density (50.0%). No pictures suggestive of scleroderma pattern have been observed. Acute COVID-19 patients, compared to recovered patients, showed a higher prevalence of hemosiderin deposits as a result of micro-hemorrhages (P = .027) and micro-thrombosis (P < .016), sludge flow (P = .001), and pericapillary edema (P < .001), while recovered patients showed a higher prevalence of enlarged capillaries (P < .001), loss of capillaries (P = .002), meandering capillaries (P < .001), and empty dermal papillae (P = .006).
Conclusion: COVID-19 patients present microvascular abnormalities at NVC. Currently ill and recovered subjects are characterized by a different distribution of elementary capillaroscopic alterations, resembling acute and post-acute microvascular damage. Further studies are needed to assess the clinical relevance of NVC in COVID-19.
Keywords: COVID-19; Micro-thrombosis; Microangiopathy; Nailfold videocapillaroscopy.