COVID-19 Patients Have Peripheral Microvascular Dysfunction and Tissue Hypoxia in Spite of Successful Treatment of Lung Failure: A Proof of Concept Study

IF 1.9 4区医学 Q3 HEMATOLOGY

Microcirculation Pub Date : 2025-07-01 DOI:10.1111/micc.70014

Knut Kvernebo, L. Liv Kristin Wikslund, Kamila Drezek, Andrea Jaramillo, Luigino Capone, Maged Helmy, Yunong Zhao, Aaron Aguirre, David D'Alessandro

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引用次数: 0

Abstract

Background

Availability of oxygen (O₂) is essential for life and function of all cells of the human body (n ≈ 10¹³–10¹⁴ cells). COVID-19 patients often have impaired lung function with compromised oxygen uptake, but little is known about microvascular oxygen delivery and tissue oxygenation.

Objectives

Use the Oxygen Delivery Index (ODIN) concept to assess peripheral microvascular regulation and oxygen extraction in COVID-19 patients.

Methods

The ODIN concept includes two technologies (diffuse reflectance spectroscopy—DRS and computer assisted microscopy—CAM) for data acquisition from subepidermal nutritive capillaries. Output parameters are microvascular oxygen saturation (SmvO₂) and functional capillary density (FCD).

Results

Forty patients hospitalized for COVID-19 grouped into early discharge (< 7 days, n = 11), severe (beyond 7 days, n = 24) and non-survivors (n = 5), and healthy controls (n = 23) were examined.

Microvascular oxygen saturation (SmvO₂) and the corresponding O₂ extraction (SaO₂—SmvO₂) was 56% ± 4%/42% ± 9% (mean ± SD) in healthy controls (n = 11), 61 ± 10/37 ± 10 for historic controls (n = 12), significantly different (p < 0.01) as compared with all COVID-19 groups (early discharge: 40% ± 13%/54% ± 13%, severe: 34% ± 15%/60% ± 15%, non-survivors 22% ± 15%/73% ± 16%). FCD expressed as the relative number of red pixels (belonging to a capillary erythrocyte) in a CAM frame were reduced in alle patient groups as compared to historic controls (p < 0⋅05).

Conclusion

Results show skin microvascular dysregulation and tissue hypoxia in patients, indicative of hypoxia also in other tissues. We hypothesize that tissue hypoxia is a cause of reversible and non-reversible long COVID-19 symptoms and of mortality.

查看原文本刊更多论文

尽管成功治疗了肺衰竭，但COVID-19患者仍存在周围微血管功能障碍和组织缺氧：一项概念验证研究

人体所有细胞（n≈1013-1014个细胞）的生命和功能都离不开氧气（O2）的供应。COVID-19患者通常有肺功能受损和摄氧量受损，但对微血管氧气输送和组织氧合知之甚少。目的应用氧传递指数（ODIN）概念评价新冠肺炎患者外周血微血管调节和氧提取情况。方法ODIN概念包括两种技术（漫反射光谱- drs和计算机辅助显微镜- cam），用于皮下营养毛细血管的数据采集。输出参数为微血管氧饱和度（SmvO2）和功能毛细血管密度（FCD）。结果40例COVID-19住院患者分为早期出院（7天）11例、重症（7天以上）24例、非幸存者（5例）和健康对照（23例）。健康对照组（n = 11）微血管氧饱和度（SmvO2）和相应的氧气提取量（SaO2-SmvO2）为56%±4%/42%±9%（平均±SD），历史对照组（n = 12）为61±10/37±10，与所有COVID-19组（早期出院组：40%±13%/54%±13%，重症组：34%±15%/60%±15%，非幸存者组22%±15%/73%±16%）相比差异有统计学意义（p < 0.01）。FCD表示为CAM框架中红色像素（属于毛细血管红细胞）的相对数量，与历史对照组相比，等位基因患者组的FCD减少（p < 0.05）。结论患者皮肤微血管异常，组织缺氧，提示其他组织也存在缺氧。我们假设组织缺氧是可逆和不可逆的COVID-19长期症状和死亡率的原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.