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Systemic microvascular endothelial dysfunction and disease severity in COVID-19 patients: Evaluation by laser Doppler perfusion monitoring and cytokine/chemokine analysis

2020; Elsevier BV; Volume: 134; Linguagem: Inglês

10.1016/j.mvr.2020.104119

1095-9319

Leticia R Sabioni, Andrea De Lorenzo, Cristiane da Cruz Lamas, Fabiana Muccillo, Hugo C. Castro‐Faria‐Neto, Vanessa Estato, Eduardo Tibiriçá,

Climate Change and Health Impacts

Microvascular dysfunction, serum cytokines and chemokines may play important roles in pathophysiology of coronavirus disease 2019 (COVID-19), especially in severe cases. 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. 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. 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. • During acute COVID-19, endothelium-dependent microvascular vasodilator responses are reduced. • Impaired systemic microvascular vasodilation is more evident in severe vs mild-moderate COVID-19. • Increased levels of cytokines and chemokines are associated with COVID-19 severity.