Microvascular Flow and Reactivity in Patients Presenting in the Acute Phase of COVID-19.

National Institute of Cardiology, Laranjeiras, Brazil

Status: Completed

Conditions: Microvascular Rarefaction; Endothelial Dysfunction; Coronavirus Infection

Treatments: Other: evaluation of skin microvascular flow and reactivity

Study type: Observational

Funder types: Other

Identifiers

NCT04406545

#CAAE 31237220.1.0000.5272

Details and patient eligibility

About

Considering that the intensity of systemic microvascular changes in patients in the acute phase of COVID-19 could be related to disease progression and prognosis, the present cross-sectional and observational study aims to investigate the presence of endothelial dysfunction in these patients, also looking for to evaluate associations between the presence of endothelial dysfunction and demographic, clinical and laboratory variables.

Full description

An association between the presence of previous cardiovascular disease and adverse prognosis has been demonstrated in patients with COVID-19 (coronavirus disease-19), presenting increases of up to 5-10 times in mortality.

As an initial process, the SARS-CoV-2 virus, anchored in the transmembrane angiotensin-converting enzyme 2 (ECA2), penetrates host cells, including endothelial cells, pericytes and macrophages, in addition to type II pneumocytes.

Cellular invasion results in massive release of several pro-inflammatory cytokines ("cytokine storm"), such as IL-1β, IFN-1 and IL-6, by the cells of the immune system. In turn, cytokines increase the process of vascular inflammation and the expression of leukocyte-vascular endothelium adhesion proteins, which results in endothelial activation accompanied by a pro-coagulant and pro-adhesive phenotype - between leukocytes, platelets, red blood cells and vascular endothelium - characteristic of the dysfunctional endothelium in the microcirculation, which results in severe changes in the microvascular flow and, as a result, in tissue perfusion.

It is also worth noting that the patients most vulnerable to the development of complications are those with pre-existing endothelial dysfunction, associated with several risk factors such as male gender and smoking, and comorbidities such as hypertension, diabetes and obesity, all of which are associated with poor prognosis in COVID -19.

Considering that the intensity of systemic microvascular changes in patients in the acute phase of COVID-19 could be related to disease progression and prognosis, the present cross-sectional and observational study aims to investigate the presence of endothelial dysfunction in these patients, also evaluating associations between the presence of endothelial dysfunction and demographic, clinical and laboratory variables.

Enrollment: 25 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

• Age> 18 years admitted to the hospital
• SARS-CoV-2 positive real-time PCR molecular test

Exclusion Criteria:

• Presence of non-COVID infection with systemic and microbiologically documented repercussions.

Trial design

25 participants in 3 patient groups

healthy volunteers

Description:

skin laser Doppler perfusion monitoring before and after local thermal hyperemia

Treatment:

Other: evaluation of skin microvascular flow and reactivity

cardiovascular disease and COVID-19 infection

Description:

skin laser Doppler perfusion monitoring before and after local thermal hyperemia

Treatment:

Other: evaluation of skin microvascular flow and reactivity

cardiovascular disease without COVID-19 infection

Description:

skin laser Doppler perfusion monitoring before and after local thermal hyperemia