Microvascular alterations in patients with SARS-COV-2 severe pneumonia

Casarotta, Erika; Scorcella, Claudia; Domizi, Roberta; Adrario, Erica; Donati, Abele

doi:10.1186/s13613-020-00680-w

Cited by 46 publications

(54 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both previous conditions are likely to affect organ microcirculation and our findings showing impairment of both density and flow parameters suggest that monitoring sublingual microcirculation may provide clinically relevant information regarding the severity of the SARS-CoV-2. Moreover, we confirmed results from our previously report showing an inverse correlation between density parameters of microcirculation and D-dimer levels ( Damiani et al, 2020 ). Interesting, this relation was confirmed in patients undergoing extracorporeal support with prolonged activated partial thromboplastin time (aPTT) due to heparin anticoagulation.…”

Section: Discussionsupporting

confidence: 92%

“…Microvascular parameters of patients with SARS-CoV-2 supported with VV-ECMO reported in our report were worse than those recorded in a mixed population of critically ill patients ( Scorcella et al, 2018 ) but comparable to our previous report including SARS-CoV-2 patients not supported by ECMO ( Damiani et al, 2020 ). This is an indirect evidence that ECMO per se is not able to improve microvascular alterations.…”

Section: Discussionsupporting

confidence: 84%

“…Monitoring of sublingual microcirculation provides clinically relevant information representative of microcirculatory alterations of other organ beds ( Guven et al, 2020 ). We recently reported the presence of microcirculatory alterations in patients with SARS-CoV-2 ( Damiani et al, 2020 ). Thus, the aim of this study was to describe the alterations of sublingual microcirculation in patients with SARS-CoV-2 treated with VV-ECMO and to assess relationship between microvascular parameters and ventilation, hemodynamics, and laboratory tests.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sublingual microcirculation in patients with SARS-CoV-2 undergoing veno-venous extracorporeal membrane oxygenation

Casarotta

Scorcella

Domizi

et al. 2020

Microvascular Research

Self Cite

View full text Add to dashboard Cite

Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) is a rescue treatment for severe acute respiratory failure refractory to conventional ventilation. We examined the alterations of sublingual microcirculation in patients with SARS-CoV-2 during VV-ECMO treatment and assessed the relationship between microvascular parameters and ventilation, hemodynamics, and laboratory tests. Nine patients were included in the study and the following microcirculatory parameters were estimated: TVD 16.81 (14.46–18.6) mm/mm 2 ; PVD 15.3 (14.09–17.96) mm/mm 2 ; PPV 94.85% (93.82%–97.79%); MFI 2.5 (2.5–2.92); HI 0.4 (0.18–0.4). TVD and PVD were inversely related to D-dimer levels (rho = −0.667, p = 0.05 and rho = −0.733, p = 0.025 respectively), aspartate aminotransferase (AST) (rho = −0.886, p = 0.019 and rho = −0.886, p = 0.019 respectively) and alanine aminotransferase (ALT) (rho = −0.829, p = 0.042 and rho = −0.829, p = 0.042 respectively). Our results showed an altered sublingual microcirculation in patients receiving VV-ECMO for severe SARS-CoV-2 and suggest a potential contribution of endothelia dysfunction to determine microvascular alteration.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sublingual microcirculation in patients with SARS-CoV-2 undergoing veno-venous extracorporeal membrane oxygenation

Casarotta

Scorcella

Domizi

et al. 2020

Microvascular Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…A detailed overview of study characteristics is presented in the Supplementary data, Table S2 . Most studies (84 studies) reported data on COVID-19 patients from China [ 3 , 4 , 10 , 11 , 28–38 , 42–44 , 46–53 , 55 , 56 , 58–77 , 85 , 87 , 88 , 90 , 107–109 , 112 , 118–123 , 132–135 , 137–140 , 142 , 143 , 146–148 , 150–160 ], 27 studies were conducted in the USA [ 11 , 12 , 25 , 27 , 40 , 57 , 78 , 81 , 84 , 94 , 98–101 , 103 , 105 , 111 , 114 , 116 , 124 , 129–131 , 136 , 141 , 145 , 149 , 163 ], 23 studies reported data from Europe [ 26 , 39 , 45 , 54 , 80 , 82 , 83 , 86 , 89 , 91–93 , 95–97 , …”

Section: Resultsmentioning

confidence: 99%

Acute kidney injury and kidney replacement therapy in COVID-19: a systematic review and meta-analysis

Janse

Jong

et al. 2020

Clinical Kidney Journal

View full text Add to dashboard Cite

Background Acute kidney injury (AKI) can affect hospitalized patients with coronavirus disease 2019 (COVID-19), with estimates ranging between 0.5% and 40%. We performed a systematic review and meta-analysis of studies reporting incidence, mortality and risk factors for AKI in hospitalized COVID-19 patients. Methods We systematically searched 11 electronic databases until 29 May 2020 for studies in English reporting original data on AKI and kidney replacement therapy (KRT) in hospitalized COVID-19 patients. Incidences of AKI and KRT and risk ratios for mortality associated with AKI were pooled using generalized linear mixed and random-effects models. Potential risk factors for AKI were assessed using meta-regression. Incidences were stratified by geographic location and disease severity. Results A total of 3042 articles were identified, of which 142 studies were included, with 49 048 hospitalized COVID-19 patients including 5152 AKI events. The risk of bias of included studies was generally low. The pooled incidence of AKI was 28.6% [95% confidence interval (CI) 19.8–39.5] among hospitalized COVID-19 patients from the USA and Europe (20 studies) and 5.5% (95% CI 4.1–7.4) among patients from China (62 studies), whereas the pooled incidence of KRT was 7.7% (95% CI 5.1–11.4; 18 studies) and 2.2% (95% CI 1.5–3.3; 52 studies), respectively. Among patients admitted to the intensive care unit, the incidence of KRT was 20.6% (95% CI 15.7–26.7; 38 studies). Meta-regression analyses showed that age, male sex, cardiovascular disease, diabetes mellitus, hypertension and chronic kidney disease were associated with the occurrence of AKI; in itself, AKI was associated with an increased risk of mortality, with a pooled risk ratio of 4.6 (95% CI 3.3–6.5). Conclusions AKI and KRT are common events in hospitalized COVID-19 patients, with estimates varying across geographic locations. Additional studies are needed to better understand the underlying mechanisms and optimal treatment of AKI in these patients.

show abstract

“…Recently, Damiani et al. presented the first in vivo evaluation of the microcirculation in patients with SARS-CoV-2 severe pneumonia [ 41 ]. The authors studied sublingual microcirculation, finding an inverse correlation between perfused vessel density and D-dimer levels.…”

Section: Covid-19 As a Microvascular Diseasementioning

confidence: 99%

COVID-19 and Microvascular Disease: Pathophysiology of SARS-CoV-2 Infection With Focus on the Renin-Angiotensin System

Kasal

Lorenzo

Tibiriçá

2020

Heart, Lung and Circulation

View full text Add to dashboard Cite

The recently described severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people, with thousands of fatalities. It has prompted global efforts in research, with focus on the pathophysiology of coronavirus disease-19 (COVID-19), and a rapid surge of publications. COVID-19 has been associated with a myriad of clinical manifestations, including the lungs, heart, kidneys, central nervous system, gastrointestinal system, skin, and blood coagulation abnormalities. The endothelium plays a key role in organ dysfunction associated with severe infection, and current data suggest that it is also involved in SARS-CoV-2-induced sepsis. This critical review aimed to address a possible unifying mechanism underlying the diverse complications of COVID-19: microvascular dysfunction, with emphasis on the renin-angiotensin system. In addition, research perspectives are suggested in order to expand understanding of the pathophysiology of the infection.

show abstract

Microvascular alterations in patients with SARS-COV-2 severe pneumonia

Cited by 46 publications

References 6 publications

Sublingual microcirculation in patients with SARS-CoV-2 undergoing veno-venous extracorporeal membrane oxygenation

Sublingual microcirculation in patients with SARS-CoV-2 undergoing veno-venous extracorporeal membrane oxygenation

Acute kidney injury and kidney replacement therapy in COVID-19: a systematic review and meta-analysis

COVID-19 and Microvascular Disease: Pathophysiology of SARS-CoV-2 Infection With Focus on the Renin-Angiotensin System

Contact Info

Product

Resources

About