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

  • STATUS
    Recruiting
  • participants needed
    25
  • sponsor
    National Institute of Cardiology, Laranjeiras, Brazil
Updated on 19 February 2024
endothelial dysfunction
covid-19
SARS
acute respiratory syndrome (sars)

Summary

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.

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-1, 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.

Details
Condition Coronavirus Infection, Endothelial Dysfunction, Microvascular Rarefaction
Age 18years - 80years
Treatment evaluation of skin microvascular flow and reactivity
Clinical Study IdentifierNCT04406545
SponsorNational Institute of Cardiology, Laranjeiras, Brazil
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

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

Exclusion Criteria

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