Microcirculatory, Endothelial, and Inflammatory Responses in Critically Ill Patients With COVID-19 Are Distinct From Those Seen in Septic Shock: A Case Control Study

ABSTRACTCritically ill patients with COVID-19 infection frequently exhibit a hyperinflammatory response and develop organ failures, however the underlying mechanisms are unclear. We investigated the microcirculatory, endothelial and inflammatory responses in critically ill COVID-19 patients and comp...

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Published in:Shock (Augusta, Ga.) Ga.), 2021-06, Vol.55 (6), p.752-758
Main Authors: Hutchings, Sam D., Watchorn, James, Trovato, Francesca, Napoli, Salvatore, Mujib, Salma F., Hopkins, Philip, McPhail, Mark
Format: Article
Language:English
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Summary:ABSTRACTCritically ill patients with COVID-19 infection frequently exhibit a hyperinflammatory response and develop organ failures, however the underlying mechanisms are unclear. We investigated the microcirculatory, endothelial and inflammatory responses in critically ill COVID-19 patients and compared them to a group of patients with septic shock in a prospective observational case control study. 30 critically ill patients with COVID-19 were compared to 33 patients with septic shock.Measurements of sublingual microcirculatory flow using Incident Dark Field (IDF) video-microscopy and serial measurements of IL-6 and Syndecan-1 levels were performed. COVID-19 patients had significantly less vasoactive drug requirement and lower plasma lactate than those with septic shock. Microcirculatory flow was significantly worse in septic patients than those with COVID-19 (MFI 2.6 v 2.9 p 0.02, PPV 88 v 97% p 
ISSN:1073-2322
1540-0514
DOI:10.1097/SHK.0000000000001672