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Microvasc Res . Systemic microvascular endothelial dysfunction and disease severity in COVID-19 patients: Evaluation by laser Doppler perfusion mon

tetano

Editor, Senior Moderator
Microvasc Res


. 2020 Dec 2;104119.
doi: 10.1016/j.mvr.2020.104119. Online ahead of print.
Systemic microvascular endothelial dysfunction and disease severity in COVID-19 patients: Evaluation by laser Doppler perfusion monitoring and cytokine/chemokine analysis


Let?cia Sabioni[SUP] 1 [/SUP], Andrea De Lorenzo[SUP] 1 [/SUP], Cristiane Lamas[SUP] 1 [/SUP], Fabiana Muccillo[SUP] 1 [/SUP], Hugo Caire Castro-Faria-Neto[SUP] 2 [/SUP], Vanessa Estato[SUP] 2 [/SUP], Eduardo Tibirica[SUP] 3 [/SUP]



Affiliations

Abstract

Background: Microvascular dysfunction, serum cytokines and chemokines may play important roles in pathophysiology of coronavirus disease 2019 (COVID-19), especially in severe cases.
Methods: Patients with COVID-19 underwent non-invasive evaluation of systemic endothelium-dependent microvascular reactivity - using laser Doppler perfusion monitoring in the skin of the forearm - coupled to local thermal hyperemia. Maximal microvascular vasodilatation (44? C thermal plateau phase) was used as endpoint. A multiplex biometric immunoassay was used to assess a panel of 48 serum cytokines and chemokines. Severe COVID-19 (S-COVID) was defined according to WHO criteria, while all other cases of COVID-19 were considered mild to moderate (M-COVID). A group of healthy individuals who tested negative for SARS-CoV-2 served as a control group and was also evaluated with LDPM.
Results: Thirty-two patients with COVID-19 (25% S-COVID) and 14 controls were included. Basal microvascular flow was similar between M-COVID and controls (P=0.69) but was higher in S-COVID than in controls (P=0.005) and M-COVID patients (P=0.01). The peak microvascular vasodilator response was markedly decreased in both patient groups (M-COVID, P=0.001; S-COVID, P<0.0001) compared to the healthy group. The percent increases in microvascular flow were markedly reduced in both patient groups (M-COVID, P<0.0001; S-COVID, P<0.0001) compared to controls. Patients with S-COVID had markedly higher concentrations of dissimilar proinflammatory cytokines and chemokines, compared to patients with M-COVID.
Conclusions: In patients with COVID-19, especially with S-COVID, endothelium-dependent microvascular vasodilator responses are reduced, while serum cytokines and chemokines involved in the regulation of vascular function and inflammation are increased.

Keywords: COVID-19; endothelial dysfunction; laser Doppler perfusion monitoring; proinflammatory cytokines.
 
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