Dynamics of morphofunctional indexes of microcirculatory bloodstream in a patient who have suffered from COVID-19


DOI: https://dx.doi.org/10.18565/therapy.2021.6.109-115

Kheilo T.S., Gladysheva E.G., Danilogorskaya Yu.A., Dzhavatkhanova M.R.

1) LLC «Center for Therapeutic Ophthalmology» (LLC «CTO»), Moscow; 2) I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)
Abstract. In the pathogenesis of COVID-19, a significant role is assigned to microcirculation disorders. A number of works performed by various methods in vivo have shown similar disorders in patients with a new coronavirus infection at various stages of the disease. However, there have been no studies on the non-invasive research of microcirculation parameters in patients before the beginning of new coronavirus infection and at the stage of resolution of polysegmental pneumonia associated with COVID-19. In the represented clinical case, using bulbar microscopy, we revealed a significant declination of microcirculation indexes in a patient with pneumonia associated with COVID-19, at the resolution stage, compared with the initial data before the start of the disease, which suggests the influence of COVID-19 at the morphofunctional parameters of the microcirculatory bloodstream. The obtained data are consistent with the concept of the role of microcirculation disorders caused by endothelial damage in COVID-19 pathogenesis.
Keywords: bulbar capillaroscopy, COVID-19, coronavirus infection, microcirculation
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Literature


  1. Quinaglia T., Shabani M., Breder I. et al. Coronavirus disease-19: The multi-level, multi-faceted vasculopathy. Atherosclerosis. 2021; 322: 39–50. doi: 10.1016/j.atherosclerosis.2021.02.009.

  2. Varga Z., Flammer A.J., Steiger P. et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020; 395(10234): 1417–18. doi: 10.1016/S0140-6736(20)30937-5.

  3. Mondal R., Lahiri D., Deb S. et al. COVID-19: Are we dealing with a multisystem vasculopathy in disguise of a viral infection? J Thromb Thrombolysis. 2020; 50(3): 567–79. doi: 10.1007/s11239-020-02210-8.

  4. Tibirica E., De Lorenzo A. Importance of the evaluation of systemic microvascular flow and reactivity in critically ill patients with coronavirus disease 2019 – COVID-19. Microvasc Res. 2020; 131: 104028. doi: 10.1016/j. mvr.2020.104028.

  5. Gupta A., Madhavan M.V., Sehgal K. et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020; 26(7): 1017–32. doi: 10.1038/s41591-020-0968-3.

  6. Huertas A., Montani D., Savale L. et al. Endothelial cell dysfunction: A major player in SARS-CoV-2 infection (COVID-19)? Eur Respir J. 2020; 56(1): 2001634. doi: 10.1183/13993003.01634-2020.

  7. Bikdeli B., Madhavan M.V., Jimenez D. et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. J Am Coll Cardiol. 2020; 75(23): 2950–73. doi: 10.1016/j.jacc.2020.04.031.

  8. Levi M., Thachil J., Iba T., Levy J.H. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020; 7(6): e438–e440. doi: 10.1016/S2352-3026(20)30145-9.

  9. Martini R. The compelling arguments for the need of microvascular investigation in COVID-19 critical patients. Clin Hemorheol Microcirc. 2020; 75(1): 27–34. doi: 10.3233/CH200895.

  10. Петрищев Н.Н., Халепо О.В., Вавиленкова Ю.А., Власов Т.Д. COVID-19 и сосудистые нарушения (обзор литературы). Регионарное кровообращение и микроциркуляция. 2020; 3: 90–98. [Petrishchev N.N., Khalepo O. V., Vavilenkova Yu.A., Vlasov T.D. COVID-19 and vascular disorders (literature review). Regionarnoe krovoobrashcheniye i mikrotsirkulyatsiya = Regional hemodynamics and microcirculation. 2020; 3:90–98 (In Russ.)]. doi: https://doi.org/10.24884/1682-6655-2020-19-3-90-98.

  11. Kanoore Edul V.S., Caminos Eguillor J.F., Ferrara G. et al. Microcirculation alterations in severe COVID-19 pneumonia. J Crit Care. 2021; 61: 73–75. doi: 10.1016/j.jcrc.2020.10.002.

  12. Damiani E., Carsetti A., Casarotta E. et al. Microvascular alterations in patients with SARS-CoV-2 severe pneumonia. Ann Intensive Care. 2020; 10(1): 60. doi: 10.1186/s13613-020-00680-w.

  13. Глазкова П.А., Куликов Д.А., Рогаткин Д.А. с соавт. Неинвазивная оценка кожной микроциркуляции крови у пациентов с COVID-19. Три клинических наблюдения. Альманах клинической медицины. 2020; 48: 27–31. [Glazkova P.A., Kulikov D.A., Rogatkin D.A. et al. Non-invasive assessment of skin microcirculation in patients with COVID-19: three clinical cases. Al’manakh klinicheskoy meditsiny = Almanac of Clinical Medicine. 2020; 48: 27–31 (In Russ.)]. doi: https://doi.org/10.18786/2072-0505-2020-48-037.

  14. Jung E.M., Stroszczynski C., Jung F. Contrast enhanced ultrasonography (CEUS) to detect abdominal microcirculatory disorders in severe cases of COVID-19 infection: First experience. Clin Hemorheol Microcirc. 2020; 74(4): 353–61. doi: 10.3233/CH-209003.

  15. Natalello G., De Luca G., Gigante L. et al. Nailfold capillaroscopy findings in patients with coronavirus disease 2019: Broadening the spectrum of COVID-19 microvascular involvement. Microvasc Res. 2021; 133: 104071. doi: 10.1016/j.mvr.2020.104071.

  16. Козлов В.И. Капилляроскопия в клинической практике. М.: Практическая медицина. 2015; 232 с. [Kozlov V.I. Capillaroscopy in clinical practice. Moscow: Prakticheskaya mediczina = Practical Medicine., 2015; 232pp. (In Russ.)]. ISBN: 978-5-98811-342-3.

  17. Hernandez A., Vinals M., Pablos A. et al. Ozone therapy for patients with COVID-19 pneumonia: Preliminary report of a prospective case-control study. Int Immunopharmacol. 2021; 90: 107261. doi: 10.1016/j.intimp.2020.107261.

  18. Shah M., Captain J., Vaidya V. et al. Safety and efficacy of ozone therapy in mild to moderate COVID-19 patients: A phase 1/11 randomized control trial (SEOT study). Int Immunopharmacol. 2021; 91: 107301. doi: 10.1016/j.intimp.2020.107301.


About the Autors

Tatyana S. Kheilo, ophthalmologist, chief physician of the Center for Therapeutic Ophthalmology LLC (CTO LLC). Address: 117218, Moscow, 18/2 Krzhizhanovskogo Str. Tel.: +7 (985) 769-73-50. E-mail: cto96@mail.ru. ORCID: 0000-0002-8374-2645
Ekaterina G. Gladysheva, PhD, assistant of the Department of hospital therapy No. 1 of N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 129090, Moscow, 3/1 Bolshaya Sukharevskaya Sq. Tel.: +7 (903) 670-69-81. E-mail: еglad8@mail.ru. ORCID: 0000-0002-4079-7689
Yulia A. Danilogorskaya, PhD, assistant of the Department of hospital therapy No. 1 of N.V. Sklifosovsky Institute of clinical medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 129090, Moscow, 3/1 Bolshaya Sukharevskaya Sq. Tel.: +7 (916) 612-98-14. E-mail: julia_dan@mail.ru. ORCID: 0000-0002-4994-8500
Muminat R. Dzhavatkhanova, 5th year student of N.V. Sklifosovsky Institute of clinical medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 129090, Moscow, 3/1 Bolshaya Sukharevskaya Sq. E-mail: mmm-2200@mail.ru. ORCID: 0000-0003-4182-2505


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