The potential of high-frequency ultrasound Dopplerography in the assessment of microcirculatory disorders in post-COVID-19 patients with a cardiovascular profile

Abstract

Introduction. Patients with cardiovascular diseases have endothelial dysfunction and a higher risk of severe course of COVID-19, and thrombotic complications. Associated endotheliitis caused by virus penetration and cytokines storm leads to the release of tissue factor, the formation of excess thrombin and fibrin and thrombosis. The aim. To identify the potential of high-frequency ultrasound Dopplerography (HFUDG) for the assessment of microcirculatory disorders in post-COVID-19 patients with cardiovascular profile and to assess the microcirculatory bed condition before and after treatment with sulodexide. Materials and methods. 49 patients recovered from moderate-severe COVID-19 one month ago, aged 20–80, were examined. 24 patients, received prophylaxis with POACs for 1 month, formed group I, group II – 25 patients without prophylaxis. The nail bed of the upper limb 1st finger was examined using HFUDG and a 25 MHz sensor. Shape and spectrum of curves taken from dopplerograms were analyzed. The control examination was performed 4 weeks after therapy. Results. In patients after COVID19, depletion of spectral characteristics was revealed in comparison with dopplerograms of healthy individuals. The predominantly red part of the spectrum corresponding to the fastest particles was recorded. Slow-moving particles corresponding to the lighter part of the spectrum were nearly non-existent. In patients administrated POAC prophylaxis, amplitude indices were higher. Significant increase in D-dimer, antithrombin III, and soluble fibrin monomer complexes (SFMC) was also detected. The remaining parameters of the coagulogram were within the norm before and after treatment. After a course of sulodexide therapy, the spectral characteristics and coagulogram parameters returned to normal. Conclusion. HFUDG allows to detect stasis of capillary blood flow, the appearance of shunt blood flow corresponding to microtrombosis. Microcirculation indicators in post-COVID-19 patients improved after a course of preventive therapy with sulodexide.