In vivo demonstration of microvascular thrombosis in severe COVID-19

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Author(s):	do Espirito Santo, Douglas Alexandre ; Bertoldi Lemos, Anna Cristina ; Miranda, Carlos Henrique Total Authors: 3
Document type:	Journal article
Source:	JOURNAL OF THROMBOSIS AND THROMBOLYSIS; v. 50, n. 4, p. 5-pg., 2020-08-13.
Abstract
Several autopsy studies showed microthrombi in pulmonary circulation of severe COVID-19 patients. The major limitation of these investigations is that the autopsy provided static information. Some of these alterations could be secondary to the disseminated intravascular coagulation (DIC) observed as the final standard route to the multisystem organ failure exhibited in critically ill patients. We report preliminary results of an in vivo evaluation of sublingual microcirculation in thirteen patients with severe COVID-19 requiring mechanical ventilation. We observed multiple filling defects moving within the microvessels indicative of thrombi in most of the cases 11/13 (85%). This is the first imaging documentation of microvascular thrombosis in living severe COVID-19 patients since the beginning of the hospitalization. The clinical relevance of microvascular thrombosis in this disease requires further research. (AU)

FAPESP's process:	19/06187-1 - Evaluation of the endothelial glycocalyx damage in the microcirculation alterations associated to the circulatory shock
Grantee:	Carlos Henrique Miranda
Support Opportunities:	Regular Research Grants