Impaired skin microvascular endothelial reactivity in critically ill COVID-19 patients,Annals of Intensive Care

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Impaired skin microvascular endothelial reactivity in critically ill COVID-19 patients
Annals of Intensive Care ( IF 8.1 ) Pub Date : 2022-06-13 , DOI: 10.1186/s13613-022-01027-3
Lisa Raia ₁ , Tomas Urbina ₁ , Paul Gabarre ₁ , Vincent Bonny ₁ , Geoffroy Hariri ₁ , Sebastien Ehrminger ₁ , Naïke Bigé ₁ , Jean-Luc Baudel ₁ , Bertrand Guidet _{1,

2} , Eric Maury _{1,

2,

3} , Jeremie Joffre _{1,

3} , Hafid Ait-Oufella _{1,

4}

Affiliation

Background

Some clinical and histological studies have reported that SARS-CoV-2 infection may damage the endothelium. However, the impact of this virus on endothelial function in vivo remains poorly characterized. In this single-center pilot observational study, we performed iontophoresis of acetylcholine coupled with Laser doppler to investigate microvascular endothelial reactivity in COVID-19 patients compared to patients with non-COVID-19 bacterial pneumonia (NCBP) patients.

Results

During three consecutive months, 32 COVID-19 patients and 11 control NCBP patients with acute respiratory failure were included. The median age was 59 [50–68] and 69 [57–75] years in COVID-19 and NCBP groups, respectively (P = 0.11). There was no significant difference in comorbidities or medications between the two groups, except for body mass index, which was higher in COVID-19 patients. NCBP patients had a higher SAPS II score compared to COVID-19 patients (P < 0.0001), but SOFA score was not different between groups (P = 0.51). Global hemodynamic and peripheral tissue perfusion parameters were not different between groups. COVID-19 patients had significantly lower skin microvascular basal blood flow than NCBP patients (P = 0.02). In addition, endothelium-dependent microvascular reactivity was threefold lower in COVID-19 patients than NCBP patients (P = 0.008).

Conclusions

Both baseline skin microvascular blood flow and skin endothelial-dependent microvascular reactivity were impaired in critically ill COVID-19 patients compared to NCBP patients, despite a lower disease severity score supporting a specific pathogenic role of SARS-CoV-2 on the endothelium.

中文翻译：

危重 COVID-19 患者的皮肤微血管内皮反应性受损

背景

一些临床和组织学研究报告说，SARS-CoV-2 感染可能会损害内皮细胞。然而，这种病毒对体内内皮功能的影响仍然缺乏特征。在这项单中心初步观察性研究中，我们进行了乙酰胆碱离子电渗疗法与激光多普勒相结合，以研究 COVID-19 患者与非 COVID-19 细菌性肺炎 (NCBP) 患者相比的微血管内皮反应性。

结果

在连续三个月中，纳入了 32 名 COVID-19 患者和 11 名患有急性呼吸衰竭的对照 NCBP 患者。COVID-19 和 NCBP 组的中位年龄分别为 59 [50-68] 和 69 [57-75] 岁（P = 0.11）。两组之间的合并症或药物治疗没有显着差异，除了体重指数在 COVID-19 患者中较高。与 COVID-19 患者相比，NCBP 患者的 SAPS II 评分更高（P < 0.0001），但组间 SOFA 评分无差异（P = 0.51）。总体血流动力学和外周组织灌注参数在各组之间没有差异。COVID-19 患者的皮肤微血管基础血流量显着低于 NCBP 患者（P = 0.02)。此外，COVID-19 患者的内皮依赖性微血管反应性比 NCBP 患者低三倍（P = 0.008）。