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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
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Persistent capillary rarefication in long COVID syndrome

Irina Osiaevi1, Arik Schulze1, Georg Evers1

  • 1Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Münster, 48149, Münster, Germany.

Angiogenesis
|August 11, 2022
PubMed

Insights

Long COVID causes persistent capillary rarefication, a vascular issue affecting microvessels even 18 months post-infection. This reduction in vascular density impacts microcirculation and tissue oxygenation in recovered patients.

Area of Science:

  • Cardiovascular Research
  • Infectious Diseases
  • Microcirculation Studies

Background:

  • Coronavirus disease 2019 (COVID-19) is increasingly recognized as a multisystemic vascular disease.
  • Persistent symptoms and long-term sequelae affect up to 60% of COVID-19 patients for over six months.
  • Understanding the vascular impact of COVID-19 is crucial for managing long-term patient health.

Purpose of the Study:

  • To investigate persistent microvascular changes in patients with long COVID.
  • To quantify capillary density, red blood cell velocity, and microvascular health in long COVID patients compared to controls.
  • To assess the potential for long-term vascular damage following SARS-CoV-2 infection.

Main Methods:

  • Prospective observational study of 58 participants, including 27 long COVID patients (>12 weeks post-infection).
  • Sublingual videomicroscopy with sidestream dark field imaging was performed on all participants.
  • Newly developed Glycocheck™ software quantified vascular density, perfused boundary region (PBR), red blood cell velocity (VRBC), and microvascular health score (MVHS™).

Main Results:

  • A significant decrease in vascular density was observed, specifically in very small capillaries (e.g., D5: -45.16%).
  • Capillary perfusion in long COVID patients was comparable to critically ill COVID-19 patients and inadequately responded to metabolic demand.
  • The microvascular health score (MVHS™) was markedly reduced in the long COVID cohort (2.72 points) compared to healthy controls (3.87 points).

Conclusions:

  • COVID-19 infection appears to cause persistent capillary rarefication, detectable up to 18 months post-infection.
  • The observed microvascular damage, characterized by reduced capillary density, may contribute to long COVID symptoms.
  • The reversibility and timeline of this vascular damage remain to be determined.
Abstract

Keywords:
COVID-19Endothelial glycocalyxEndotheliopathyLong COVID microcirculationMicrovascular health scoreSublingual microscopy

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