Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units

Background: COVID-19 is primarily a respiratory disease; however, there is also evidence that it causes endothelial damage in the microvasculature of several organs. The aim of the present study is to characterize in vivo the microvas‑ cular reactivity in peripheral skeletal muscle of severe COVID-1...

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Authors: Mesquida, Jaume, Caballer, Alba, Cortese, Lorenzo, Vilà, Clara, Karadeniz, Umut, Pagliazzi, Marco, Zanoletti, Marta, Pérez Pacheco, Argelia, Castro Rebollo, Pedro, García-de-Acilu, Marina, Mesquita, Rickson Coelho, Busch, David R., Durduran, Turgut, HEMOCOVID-19 Consortium
Format: article
Status:Published version
Publication Date:2021
Country:España
Institution:Universidad de Barcelona
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/186177
Online Access:https://hdl.handle.net/2445/186177
Access Level:Open access
Keyword:COVID-19
SARS-CoV-2
Unitats de cures intensives
Microcirculació
Vasos sanguinis
Espectroscòpia infraroja
Intensive care units
Microcirculation
Blood vessels
Infrared spectroscopy
id ES_ed2f82014f09e31716fa062c8cef5b96
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repository_id_str
spelling Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care unitsMesquida, JaumeCaballer, AlbaCortese, LorenzoVilà, ClaraKaradeniz, UmutPagliazzi, MarcoZanoletti, MartaPérez Pacheco, ArgeliaCastro Rebollo, PedroGarcía-de-Acilu, MarinaMesquita, Rickson CoelhoBusch, David R.Durduran, TurgutHEMOCOVID-19 ConsortiumCOVID-19SARS-CoV-2Unitats de cures intensivesMicrocirculacióVasos sanguinisEspectroscòpia infrarojaCOVID-19SARS-CoV-2Intensive care unitsMicrocirculationBlood vesselsInfrared spectroscopyBackground: COVID-19 is primarily a respiratory disease; however, there is also evidence that it causes endothelial damage in the microvasculature of several organs. The aim of the present study is to characterize in vivo the microvas‑ cular reactivity in peripheral skeletal muscle of severe COVID-19 patients. Methods: This is a prospective observational study carried out in Spain, Mexico and Brazil. Healthy subjects and severe COVID-19 patients admitted to the intermediate respiratory (IRCU) and intensive care units (ICU) due to hypox‑ emia were studied. Local tissue/blood oxygen saturation (StO2) and local hemoglobin concentration (THC) were non-invasively measured on the forearm by near-infrared spectroscopy (NIRS). A vascular occlusion test (VOT), a threeminute induced ischemia, was performed in order to obtain dynamic StO2 parameters: deoxygenation rate (DeO2), reoxygenation rate (ReO2), and hyperemic response (HAUC). In COVID-19 patients, the severity of ARDS was evaluated by the ratio between peripheral arterial oxygen saturation (SpO2) and the fraction of inspired oxygen (FiO2) (SF ratio). Results: Healthy controls (32) and COVID-19 patients (73) were studied. Baseline StO2 and THC did not difer between the two groups. Dynamic VOT-derived parameters were signifcantly impaired in COVID-19 patients showing lower metabolic rate (DeO2) and diminished endothelial reactivity. At enrollment, most COVID-19 patients were receiving invasive mechanical ventilation (MV) (53%) or high-fow nasal cannula support (32%). Patients on MV were also receiv‑ ing sedative agents (100%) and vasopressors (29%). Baseline StO2 and DeO2 negatively correlated with SF ratio, while ReO2 showed a positive correlation with SF ratio. There were signifcant diferences in baseline StO2 and ReO2 among the diferent ARDS groups according to SF ratio, but not among diferent respiratory support therapies. Conclusion: Patients with severe COVID-19 show systemic microcirculatory alterations suggestive of endothelial dysfunction, and these alterations are associated with the severity of ARDS. Further evaluation is needed to determineBioMed Central2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/186177Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1186/s13054-021-03803-2Critical Care, 2021, vol. 25, num. 1, p. 381https://doi.org/10.1186/s13054-021-03803-2info:eu-repo/grantAgreement/EC/H2020/101016087info:eu-repo/grantAgreement/EC/H2020/688303cc-by (c) Mesquida, Jaume et al., 2021https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1861772026-05-27T06:46:51Z
dc.title.none.fl_str_mv Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
title Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
spellingShingle Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
Mesquida, Jaume
COVID-19
SARS-CoV-2
Unitats de cures intensives
Microcirculació
Vasos sanguinis
Espectroscòpia infraroja
COVID-19
SARS-CoV-2
Intensive care units
Microcirculation
Blood vessels
Infrared spectroscopy
title_short Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
title_full Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
title_fullStr Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
title_full_unstemmed Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
title_sort Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units
dc.creator.none.fl_str_mv Mesquida, Jaume
Caballer, Alba
Cortese, Lorenzo
Vilà, Clara
Karadeniz, Umut
Pagliazzi, Marco
Zanoletti, Marta
Pérez Pacheco, Argelia
Castro Rebollo, Pedro
García-de-Acilu, Marina
Mesquita, Rickson Coelho
Busch, David R.
Durduran, Turgut
HEMOCOVID-19 Consortium
author Mesquida, Jaume
author_facet Mesquida, Jaume
Caballer, Alba
Cortese, Lorenzo
Vilà, Clara
Karadeniz, Umut
Pagliazzi, Marco
Zanoletti, Marta
Pérez Pacheco, Argelia
Castro Rebollo, Pedro
García-de-Acilu, Marina
Mesquita, Rickson Coelho
Busch, David R.
Durduran, Turgut
HEMOCOVID-19 Consortium
author_role author
author2 Caballer, Alba
Cortese, Lorenzo
Vilà, Clara
Karadeniz, Umut
Pagliazzi, Marco
Zanoletti, Marta
Pérez Pacheco, Argelia
Castro Rebollo, Pedro
García-de-Acilu, Marina
Mesquita, Rickson Coelho
Busch, David R.
Durduran, Turgut
HEMOCOVID-19 Consortium
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
SARS-CoV-2
Unitats de cures intensives
Microcirculació
Vasos sanguinis
Espectroscòpia infraroja
COVID-19
SARS-CoV-2
Intensive care units
Microcirculation
Blood vessels
Infrared spectroscopy
topic COVID-19
SARS-CoV-2
Unitats de cures intensives
Microcirculació
Vasos sanguinis
Espectroscòpia infraroja
COVID-19
SARS-CoV-2
Intensive care units
Microcirculation
Blood vessels
Infrared spectroscopy
description Background: COVID-19 is primarily a respiratory disease; however, there is also evidence that it causes endothelial damage in the microvasculature of several organs. The aim of the present study is to characterize in vivo the microvas‑ cular reactivity in peripheral skeletal muscle of severe COVID-19 patients. Methods: This is a prospective observational study carried out in Spain, Mexico and Brazil. Healthy subjects and severe COVID-19 patients admitted to the intermediate respiratory (IRCU) and intensive care units (ICU) due to hypox‑ emia were studied. Local tissue/blood oxygen saturation (StO2) and local hemoglobin concentration (THC) were non-invasively measured on the forearm by near-infrared spectroscopy (NIRS). A vascular occlusion test (VOT), a threeminute induced ischemia, was performed in order to obtain dynamic StO2 parameters: deoxygenation rate (DeO2), reoxygenation rate (ReO2), and hyperemic response (HAUC). In COVID-19 patients, the severity of ARDS was evaluated by the ratio between peripheral arterial oxygen saturation (SpO2) and the fraction of inspired oxygen (FiO2) (SF ratio). Results: Healthy controls (32) and COVID-19 patients (73) were studied. Baseline StO2 and THC did not difer between the two groups. Dynamic VOT-derived parameters were signifcantly impaired in COVID-19 patients showing lower metabolic rate (DeO2) and diminished endothelial reactivity. At enrollment, most COVID-19 patients were receiving invasive mechanical ventilation (MV) (53%) or high-fow nasal cannula support (32%). Patients on MV were also receiv‑ ing sedative agents (100%) and vasopressors (29%). Baseline StO2 and DeO2 negatively correlated with SF ratio, while ReO2 showed a positive correlation with SF ratio. There were signifcant diferences in baseline StO2 and ReO2 among the diferent ARDS groups according to SF ratio, but not among diferent respiratory support therapies. Conclusion: Patients with severe COVID-19 show systemic microcirculatory alterations suggestive of endothelial dysfunction, and these alterations are associated with the severity of ARDS. Further evaluation is needed to determine
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/186177
url https://hdl.handle.net/2445/186177
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s13054-021-03803-2
Critical Care, 2021, vol. 25, num. 1, p. 381
https://doi.org/10.1186/s13054-021-03803-2
info:eu-repo/grantAgreement/EC/H2020/101016087
info:eu-repo/grantAgreement/EC/H2020/688303
dc.rights.none.fl_str_mv cc-by (c) Mesquida, Jaume et al., 2021
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Mesquida, Jaume et al., 2021
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869423431928250368
score 15.301629

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