Sulli Alberto, Gotelli Emanuele, Bica Pietro Francesco, Schiavetti Irene, Pizzorni Carmen, Aloè Teresita, Grosso Marco, Barisione Emanuela, Paolino Sabrina, Smith Vanessa, Cutolo Maurizio
Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy.
Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy.
Microvasc Res. 2022 Jul;142:104361. doi: 10.1016/j.mvr.2022.104361. Epub 2022 Mar 24.
COVID-19 is a multisystem disease that causes endothelial dysfunction and organ damage. Aim of the study was to evaluate the microvascular status in COVID-19 survivors with past different disease severity, in comparison with age and sex-matched primary Raynaud's phenomenon (PRP) patients and control subjects (CNT), including possible effects of concomitant therapies.
Sixty-one COVID-19 survivors (mean age 58 ± 13 years, mean days from disease onset 126 ± 53 and mean days from recovery 104 ± 53), thirty-one PRP patients (mean age 59 ± 15 years, mean disease duration 11 ± 10 years) and thirty CNT (mean age 58 ± 13 years) underwent nailfold videocapillaroscopy (NVC) examination. The following capillaroscopic parameters were searched and scored (0-3): dilated capillaries, giant capillaries, isolated microhemorrhages, capillary ramifications (angiogenesis) and capillary number, including absolute capillary number per linear millimeter at the nailfold bed.
The mean nailfold capillary number per linear millimeter was significantly lower in COVID-19 survivors when compared with PRP patients and CNT (univariate and multivariate analysis p < 0.001). On the contrary, COVID-19 survivors showed significantly less isolated microhemorrhages than PRP patients and CNT (univariate and multivariate analysis, p = 0.005 and p = 0.012, respectively). No statistically significant difference was observed between COVID-19 survivors and control groups concerning the frequency of dilated capillaries and capillary ramifications. COVID-19 selective therapies showed a promising trend on preserving capillary loss and deserving further investigations.
SARS-CoV-2 seems to mainly induce a significant loss of capillaries in COVID-19 survivors at detailed NVC analysis in comparison to controls. The presence of a significant reduced score for isolated microhaemorrhages in COVID-19 survivors deserves further analysis.
新型冠状病毒肺炎（COVID-19）是一种多系统疾病，可导致内皮功能障碍和器官损伤。本研究的目的是评估不同疾病严重程度的COVID-19康复者的微血管状态，并与年龄和性别匹配的原发性雷诺现象（PRP）患者及对照者（CNT）进行比较，包括联合治疗的可能影响。
61例COVID-19康复者（平均年龄58±13岁，发病平均天数126±53天，康复平均天数104±53天）、31例PRP患者（平均年龄59±15岁，平均病程11±10年）和30例对照者（平均年龄58±13岁）接受了甲襞微血管镜检查（NVC）。对以下微血管镜参数进行搜索并评分（0-3分）：扩张的毛细血管、巨大毛细血管、孤立性微出血、毛细血管分支（血管生成）和毛细血管数量，包括甲襞床每线性毫米的绝对毛细血管数量。
与PRP患者和对照者相比，COVID-19康复者每线性毫米的平均甲襞毛细血管数量显著降低（单因素和多因素分析，p<0.001）。相反，COVID-19康复者的孤立性微出血明显少于PRP患者和对照者（单因素和多因素分析，分别为p=0.005和p=0.012）。COVID-19康复者与对照组在扩张毛细血管和毛细血管分支频率方面未观察到统计学显著差异。COVID-19的选择性治疗在保留毛细血管损失方面显示出有前景的趋势，值得进一步研究。
与对照组相比，在详细的NVC分析中，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）似乎主要导致COVID-19康复者出现显著的毛细血管损失。COVID-19康复者孤立性微出血评分显著降低值得进一步分析。
