• Kanoore Edul Vanina Siham VS Hospital Juan A Fernández, Ciudad Autónoma de Buenos Aires, Argentina; Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Univer, Caminos Eguillor Juan Francisco JF Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina; Hospital San Mar, Gonzalo Ferrara, Elisa Estenssoro, Daniel Shiovan Páez Siles, Cristián Emanuel Cesio, and Arnaldo Dubin.
• Hospital Juan A Fernández, Ciudad Autónoma de Buenos Aires, Argentina; Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina; Sanatorio Otamendi, Buenos Aires, Argentina.
• J Crit Care. 2021 Feb 1; 61: 73-75.

PurposeTo assess the presence of sublingual microcirculatory and skin perfusion alterations in COVID-19 pneumonia.Materials And MethodsThis is a preliminary report of a prospective observational study performed in four teaching intensive care units. We studied 27 mechanically ventilated patients with acute respiratory distress syndrome secondary to COVID-19. Sublingual microcirculation was assessed by hand-held videomicroscopy. A software-assisted analysis of videos was performed. We also measured capillary refill time.ResultsPatients were hemodynamically stable with normal lactate (1.8 [1.6-2.5] mmol/L) and high D-dimer (1.30 [0.58-2.93] μg/mL). Capillary refill time was prolonged (3.5 [3.0-5.0] s). Compared to previously reported normal values, total and perfused vascular density (21.9 ± 3.9 and 21.0 ± 3.5 mm/mm2) and heterogeneity flow index (0.91 ± 0.24) were high; and the proportion of perfused vessels (0.96 ± 0.03), microvascular flow index (2.79 ± 0.10), and red blood cell velocity (1124 ± 161 μm/s) were reduced. The proportion of perfused vessels was inversely correlated with total vascular density (Pearson r = -0.41, P = 0.03).ConclusionsCOVID-19 patients showed an altered tissue perfusion. Sublingual microcirculation was characterized by decreases in the proportion of perfused vessel and flow velocity along with high vascular densities. This last finding might be related to enhanced angiogenesis or hypoxia-induced capillary recruitment.Copyright © 2020. Published by Elsevier Inc.

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