Nailfold capillaroscopy findings in patients with coronavirus disease 2019: Broadening the spectrum of COVID-19 microvascular involvement.
COVID-19
Micro-thrombosis
Microangiopathy
Nailfold videocapillaroscopy
Journal
Microvascular research
ISSN: 1095-9319
Titre abrégé: Microvasc Res
Pays: United States
ID NLM: 0165035
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
17
07
2020
revised:
04
09
2020
accepted:
04
09
2020
pubmed:
20
9
2020
medline:
15
12
2020
entrez:
19
9
2020
Statut:
ppublish
Résumé
Increasing evidence points to endothelial dysfunction as a key pathophysiological factor in coronavirus disease-2019 (COVID-19). No specific methods have been identified to predict, detect and quantify the microvascular alterations during COVID-19. Our aim was to assess microvasculature through nailfold videocapillaroscopy (NVC) in COVID-19 patients. We performed NVC in patients with a confirmed diagnosis of COVID-19 pneumonia. Elementary alterations were reported for each finger according to a semi-quantitative score. Capillary density, number of enlarged and giant capillaries, number of micro-hemorrhages and micro-thrombosis (NEMO score) were registered. We enrolled 82 patients (mean age 58.8 ± 13.2 years, male 68.3%) of whom 28 during the hospitalization and 54 after recovery and hospital discharge. At NVC examination we found abnormalities classifiable as non-specific pattern in 53 patients (64.6%). Common abnormalities were pericapillary edema (80.5%), enlarged capillaries (61.0%), sludge flow (53.7%), meandering capillaries and reduced capillary density (50.0%). No pictures suggestive of scleroderma pattern have been observed. Acute COVID-19 patients, compared to recovered patients, showed a higher prevalence of hemosiderin deposits as a result of micro-hemorrhages (P = .027) and micro-thrombosis (P < .016), sludge flow (P = .001), and pericapillary edema (P < .001), while recovered patients showed a higher prevalence of enlarged capillaries (P < .001), loss of capillaries (P = .002), meandering capillaries (P < .001), and empty dermal papillae (P = .006). COVID-19 patients present microvascular abnormalities at NVC. Currently ill and recovered subjects are characterized by a different distribution of elementary capillaroscopic alterations, resembling acute and post-acute microvascular damage. Further studies are needed to assess the clinical relevance of NVC in COVID-19.
Identifiants
pubmed: 32949574
pii: S0026-2862(20)30131-X
doi: 10.1016/j.mvr.2020.104071
pmc: PMC7494493
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
104071Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Références
Pediatr Dermatol. 2020 May;37(3):437-440
pubmed: 32374033
J Am Acad Dermatol. 2000 May;42(5 Pt 1):787-90
pubmed: 10775855
Microvasc Res. 2020 Sep;131:104036
pubmed: 32603698
Rheumatol Int. 2012 Oct;32(10):3039-45
pubmed: 21901350
EClinicalMedicine. 2020 Oct;27:100553
pubmed: 33043284
Arthritis Res Ther. 2014 Oct 09;16(5):462
pubmed: 25296743
Lancet Respir Med. 2020 Jul;8(7):681-686
pubmed: 32473124
Crit Care Resusc. 2020 Apr 15;22(2):95-97
pubmed: 32294809
J Am Coll Cardiol. 2020 Jun 16;75(23):2950-2973
pubmed: 32311448
Arthritis Res Ther. 2017 Jun 13;19(1):133
pubmed: 28610600
Biomed Res Int. 2015;2015:974530
pubmed: 26421308
J Thromb Haemost. 2020 Aug;18(8):2064-2065
pubmed: 32324958
Lancet Rheumatol. 2020 Jun;2(6):e325-e331
pubmed: 32501454
J Rheumatol. 2000 Jan;27(1):155-60
pubmed: 10648032
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
N Engl J Med. 2020 Jul 9;383(2):120-128
pubmed: 32437596
J Clin Med. 2020 May 11;9(5):
pubmed: 32403217
Autoimmun Rev. 2020 Mar;19(3):102458
pubmed: 31927087
Front Physiol. 2020 Aug 04;11:989
pubmed: 32848893
Med Devices (Auckl). 2014 Dec 09;7:445-52
pubmed: 25525397
Microvasc Res. 2020 May;129:103970
pubmed: 31891718
Autoimmun Rev. 2019 Nov;18(11):102394
pubmed: 31520797
Semin Arthritis Rheum. 2009 Feb;38(4):289-95
pubmed: 18166220
Lancet Diabetes Endocrinol. 2020 Sep;8(9):782-792
pubmed: 32687793
Ann Rheum Dis. 1996 Aug;55(8):507-12
pubmed: 8774177
J Heart Lung Transplant. 2020 May;39(5):405-407
pubmed: 32362390
Eur J Intern Med. 2020 Jun;76:43-49
pubmed: 32482597
Lancet Rheumatol. 2020 Aug;2(8):e465-e473
pubmed: 32835256
Ann Rheum Dis. 2008 Jun;67(6):885-7
pubmed: 18037628