Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of Russian Federation, Samory Mashela Str., 1, GSP-7, 117198 Moscow, Russia.
Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Srednyaya Kalitnikovskaya Str., 30, 109029 Moscow, Russia.
Biomolecules. 2022 Jun 3;12(6):782. doi: 10.3390/biom12060782.
For the first time, the influence of COVID-19 on blood microrheology was studied. For this, the method of filtering erythrocytes through filters with pores of 3.5 μm was used. Filterability was shown to significantly decrease with the increasing severity of the patient's condition, as well as with a decrease in the ratio of hemoglobin oxygen saturation to the oxygen fraction in the inhaled air (SpO/FiO). The filterability of ≤ 0.65, or its fast decrease during treatment, were indicators of a poor prognosis. Filterability increased significantly with an increase in erythrocyte count, hematocrit and blood concentrations of hemoglobin, albumin, and total protein. The effect of these parameters on the erythrocyte filterability is directly opposite to their effect on blood macrorheology, where they all increase blood viscosity, worsening the erythrocyte deformability. The erythrocyte filterability decreased with increasing oxygen supply rate, especially in patients on mechanical ventilation, apparently not due to the oxygen supplied, but to the deterioration of the patients' condition. Filterability significantly correlates with the C-reactive protein, which indicates that inflammation affects the blood microrheology in the capillaries. Thus, the filterability of erythrocytes is a good tool for studying the severity of the patient's condition and his prognosis in COVID-19.
这是首次研究 COVID-19 对血液微循环的影响。为此,采用了通过孔径为 3.5μm 的过滤器过滤红细胞的方法。研究表明,随着患者病情严重程度的增加,以及血红蛋白氧饱和度与吸入空气中氧气分数的比值(SpO/FiO)的降低,滤过率显著下降。滤过率≤0.65,或治疗过程中滤过率迅速下降,是预后不良的指标。红细胞滤过率随着红细胞计数、血细胞比容以及血红蛋白、白蛋白和总蛋白在血液中的浓度的增加而显著增加。这些参数对红细胞滤过率的影响与它们对血液宏观流变学的影响正好相反,因为它们都增加了血液的粘度,使红细胞的变形能力恶化。红细胞滤过率随着供氧率的增加而降低,尤其是在接受机械通气的患者中,这显然不是由于供氧,而是由于患者病情恶化。滤过率与 C 反应蛋白显著相关,这表明炎症会影响毛细血管中的血液微循环。因此,红细胞滤过率是研究 COVID-19 患者病情严重程度和预后的一个很好的工具。