Evaluation of Coronavirus Disease-2019 Patients with Nailfold Capillaroscopy

Abstract

Aim:Microvasculopathy is one of the suspected complications in Coronavirus disease-2019 (COVID-19). Nailfold capillaroscopy is a noninvasive method used to evaluate microvascularity. It can be a guide in detecting endothelial dysfunction and microvasculopathy in COVID-19 patients.Materials and Methods:Severe acute respiratory syndrome-CoV-2 polymerase chain reaction positive 54 patients were evaluated. The 2nd-5th digits of both hands were investigated by nailfold capillaroscopy. Capillary density, capillary architecture and capillary morphology were recorded. Patients with abnormal and normal nailfold capillaroscopy findings were compared in terms of COVID-19 clinical symptoms.Results:Of the patients included in the study, 72% were male and the mean age was 35.6±11.6 years. In total, 22 patients (41%) had at least 1 abnormal capillaroscopy change. Diffuse capillaroscopic abnormalities were as follows: pericapillary edema 43%, enlarged and dilated capillaries 24%, and tortiosteal capillaries 22%. Hyperinflammatory response was observed in 17% of the patients and intensive care was required in only 1 patient. The frequency of hyperinflammatory response, anticytokine use and thrombosis increased in patients with abnormal capillaroscopyConclusion:Abnormal capillaroscopy findings were found to be frequent in COVID-19 patients. Higher rates of the hyperinflammatory response and anticytokine drug use in patients with abnormal nailfold findings suggest that there may be a relationship between hyperinflammation and microvasculopathy in COVID-19. Further studies are needed to evaluate the clinical relevance of nailfold abnormalities with clinical manifestations of COVID-19 disease.

Keywords

• covid-19
• microangiopathy
• nailfold capillaroscopy