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Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Microvascular Dysfunction in Patients with Critical Covid-19, a Pilot Study.

Sara Tehrani1, Patrik Gille-Johnson

  • 1Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Division of Internal Medicine and Infectious Diseases, Stockholm, Sweden.

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Severe COVID-19 critically impairs blood vessel function, affecting both endothelial-dependent and independent responses. This microvascular dysfunction may persist for months after recovery, impacting long-term health outcomes.

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Area of Science:

  • Cardiovascular Research
  • Infectious Diseases
  • Microvascular Medicine

Background:

  • Severe COVID-19 is linked to endothelial and microvascular dysfunction.
  • Investigating these dysfunctions is crucial for understanding severe disease pathology.

Purpose of the Study:

  • To assess endothelial-dependent and independent skin microvascular reactivity in critical COVID-19 patients.
  • To compare microvascular function between critical COVID-19 patients and healthy controls.

Main Methods:

  • Laser Speckle Contrast Imaging used to measure skin perfusion.
  • Iontophoresis of acetylcholine (endothelial-dependent) and sodium nitroprusside (endothelial-independent) to assess vasodilation.
  • Measurements taken during hospitalization and 3 months post-onset, compared to controls.

Main Results:

  • Critical COVID-19 patients exhibited higher basal skin perfusion and reduced vasodilation responses to both acetylcholine and sodium nitroprusside.
  • The acetylcholine/sodium nitroprusside ratio was significantly lower in COVID-19 patients, indicating impaired endothelial function.
  • Reduced acetylcholine-mediated vasodilation persisted in survivors at 3 months post-onset.

Conclusions:

  • Critical COVID-19 is associated with significant microvascular impairment and reduced endothelial function.
  • Microvascular function may not fully recover within 3 months of disease onset.
  • This pilot study highlights the persistent vascular consequences of severe COVID-19.