A Blood Supply Pathophysiological Microcirculatory Mechanism for Long COVID
Abstract
:1. Introduction
2. Background on Long COVID and Symptoms
3. Materials and Methods
3.1. The Normative Range (NR) Diagram
3.2. Hemodynamic Decrease (HD)
3.3. Microvascular Loss (ML)
3.3.1. Vessel Density Reduction (VDR)
3.3.2. Foveal Avascular Zone Enlargement (FAZE)
3.3.3. Capillary Density Reduction (CDR)
3.3.4. Percentage of Perfused Vessel Reduction (PPVR)
3.4. Blood Supply Reduction (SR)
3.5. The Proposed Pathophysiological Microcirculatory Mechanism for Long COVID
3.6. Selection of Case–Control Studies
3.7. Statistical Analysis
4. Results
4.1. Hemodynamic Decrease (HD) Case–Control Studies [Table 1]
TISSUE | STUDY | VASCULAR BED/METHOD | HD (%) | N |
---|---|---|---|---|
Conjunctiva | Koutsiaris et al. [6] | exchange microvessels/CVC | 45 | 17 |
Skin | Zharkikh et al. [27] | wrist and shin microvessels/LDF | 29 | 23 |
Brain | Qin et al. [28] | gray matter cortex, subcortical nuclei/MRI | - | 32 |
MEDIAN | 37 | - | ||
MEAN ± SEM | 37 ± 8 | - | ||
RANGE | 16 | - | ||
TOTAL | 72 |
4.2. Microvascular Loss (ML) Case–Control Studies [Table 2, Table 3, Table 4 and Table 5]
TISSUE | STUDY | VASCULAR BED | VDR (%) | N |
---|---|---|---|---|
Retina | Savastano et al. [30] | RPCP | 3 | 80 |
Gonzalez-Zamora et al. [31] | foveal SCP | 48 | 25 | |
foveal DCP | 33 | |||
Bilbao-Malavé et al. [32] | foveal SCP | 51 | 17 | |
Abrishami et al. [33] | foveal DCP | 13 | 31 | |
Guemes-Villahoz et al. [34] | SCP and DCP | 7 | 66 | |
Hazar et al. [35] | superior sector DCP | 2 | 50 | |
Cennamo et al. [36] | whole image RPCP | 8 | 40 | |
Erogul et al. [37] | whole image SCP | 3 | 32 | |
Kalaw et al. [40] | 3 inner retinal layers | 8 | 7 | |
Urfalioğlu et al. [41] | DCP | 3 | 72 | |
El-Hadad et al. [42] | Deep macular plexus | 11 | 50 | |
RPCP | 6 | |||
Choroid | Üçer and Cevher [43] | choroidal microvessels | 6 | 65 |
Sublingual | Osiaevi et al. [44] | sublingual microvessels | 41 | 27 |
MEDIAN | 8 | - | ||
MEAN ± SEM | 16 ± 5 | - | ||
RANGE | 49 | - | ||
TOTAL | 562 |
STUDY | VASCULAR BED | FAZE (%) | N |
---|---|---|---|
Gonzalez-Zamora et al. [31] | SCP | 55 | 25 |
Bilbao-Malave et al. [32] | SCP | 65 | 17 |
Abrishami et al. [33] | whole image (SCP and DCP) | 12 | 31 |
Erogul et al. [37] | whole image (SCP and DCP) | 11 | 32 |
Dipu et al. [38] | SCP | 19 | 35 |
DCP | 15 | ||
Kal et al. [39] | SCP | 30 | 63 |
DCP | 51 | ||
Urfalioğlu et al. [41] | DCP FAZ | 20 | 72 |
MEDIAN | 20 | - | |
MEAN ± SEM | 31 ± 7 | - | |
RANGE | 54 | - | |
TOTAL | 275 |
STUDY | VASCULAR BED | CDR (%) | N |
---|---|---|---|
Çakmak et al. [45] | finger nailfold capillaries | 17 | 25 |
Sulli et al. [46] | finger nailfold capillaries | 11 * | 61 |
MEDIAN | 14 | - | |
MEAN ± SEM | 14 ± 3 | - | |
RANGE | 6 | - | |
TOTAL | 86 |
STUDY | VASCULAR BED | PPVR (%) | N |
---|---|---|---|
Koutsiaris et al. [6] | eye conjunctiva | 21 | 17 |
4.2.1. Vessel Density Reduction (VDR) Case–Control Studies [Table 2]
4.2.2. FAZ Enlargement (FAZE) Case–Control Studies [Table 3]
4.2.3. Capillary Density Reduction (CDR) Case–Control Studies [Table 4]
4.2.4. Percentage of Perfused Vessel Reduction (PPVR) Case–Control Studies [Table 5]
4.3. Blood Supply Reduction (SR) [Table 6]
TISSUE (DATA SOURCE) | α (%) | HD (%) | SR (%) | N | |
---|---|---|---|---|---|
PPVR (%) | VDR (%) | ||||
Conjunctiva (Table 1 and Table 5) | 21 | - | 45 | 57 | 17 |
Conjunctiva/Skin/Brain (Table 1) | - | - | 37 | - | 72 |
Retina/Choroid/Sublingual (Table 2) | - | 16 | - | - | 562 |
Multiple Tissues (Table 1 and Table 2) | - | 16 | 37 | 47 | 634 |
4.4. Results Supporting the Proposed Mechanism
5. Discussion
6. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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Koutsiaris, A.G. A Blood Supply Pathophysiological Microcirculatory Mechanism for Long COVID. Life 2024, 14, 1076. https://doi.org/10.3390/life14091076
Koutsiaris AG. A Blood Supply Pathophysiological Microcirculatory Mechanism for Long COVID. Life. 2024; 14(9):1076. https://doi.org/10.3390/life14091076
Chicago/Turabian StyleKoutsiaris, Aristotle G. 2024. "A Blood Supply Pathophysiological Microcirculatory Mechanism for Long COVID" Life 14, no. 9: 1076. https://doi.org/10.3390/life14091076