zabmedvestnikЗабайкальский медицинский вестникTransbaikalian Medical Bulletin1998-6173Читинская государственная медицинская академия10.52485/19986173_2021_3_51zabmedvestnik-88Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHИЗМЕНЕНИЯ СИСТЕМНОГО КРОВОТОКА И МИКРОЦИРКУЛЯЦИИ ПРИ РАЗЛИЧНЫХ ИСХОДАХ COVID-19CHANGES IN SYSTEMIC BLOOD FLOW AND MICROCIRCULATION AT DIFFERENT OUTCOMES OF COVID-19ШаповаловЮ. К.ShapovalovJu. K.

672000, г. Чита, ул. Горького, 39а

39a Gorky str., Chita, 672000

ШилинД. Н.ShilinD.  N.

672000, г. Чита, ул. Горького, 39а

39a Gorky str., Chita, 672000

СмоляковЮ. Н.SmoljakovJu. N.

672000, г. Чита, ул. Горького, 39а; 672038, г. Чита, ул. Коханского, 13 

39a Gorky str., Chita, 672000; Chita

ШаповаловК. Г.ShapovalovK. G.

672000, г. Чита, ул. Горького, 39а

39a Gorky str., Chita, 672000

КузникБ. И.KuznikB. I.

672000, г. Чита, ул. Горького, 39а; 672038, г. Чита, ул. Коханского, 13 

39a Gorky str., Chita, 672000; Chita

Федеральное государственное бюджетное образовательное учреждение высшего образования «Читинская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияChita State Medical AcademyRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Читинская государственная медицинская академия» Министерства здравоохранения Российской Федерации; Иновационная клиника Академия здоровьяРоссияChita State Medical Academy; Innovative Clinic Academy of HealthRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Читинская государственная медицинская академия» Министерства здравоохранения Российской Федерации; Иновационная клиника Академия здоровьяРоссияChita State Medical Academy; Innovative Clinic Academy of HealthRussian Federation202101082024035158Copyright © Шаповалов Ю.К., Шилин Д.Н., Смоляков Ю.Н., Шаповалов К.Г., Кузник Б.И., 20242024Шаповалов Ю.К., Шилин Д.Н., Смоляков Ю.Н., Шаповалов К.Г., Кузник Б.И.Shapovalov J.K., Shilin D.N., Smoljakov J.N., Shapovalov K.G., Kuznik B.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.zabmedvestnik.ru/jour/article/view/88

В патогенезе неблагоприятного течения новой коронавирусной инфекции COVID-19 существенное значения имеют отклонения состояния кровотока.

Цель исследования

Цель исследования: сопоставить ранние изменения состояния кровотока при COVID-19 с исходом заболевания. Материалы и методы исследования. У 55 больных тяжелой формой COVID-19 в ранней респираторной фазе проведено одновременное исследование состояния макрогемодинамики неинвазивным методом объемной компрессионной осциллометрии и микроциркуляции с помощью датчика mDLS (Dynamic Light Scattering, Rehovot, Israel). В последующем выделены группа пациентов (36 человек), которые выписаны из стационара в связи с выздоровлением, и группа больных (19 человек), у которых заболевание закончилось летальным исходом.

Результаты

Результаты. В группе с благоприятным исходом COVID-19 оказалось выше значение среднего артериального давления, скорости пульсового артериального давления, показатели сердечной деятельности и скорости пульсовой волны. Одновременно у умерших пациентов резко снижался гемодинамический индекс осевого высокочастотного потока системы микроциркуляции. Выявленные отклонения параметров гемодинамики и микрокровотока свидетельствуют об изменениях состояния гемоциркуляции в сосудах разного диаметра, что является существенным звеном патогенеза тяжелого течения COVID-19. При прогрессировании несостоятельности кровообращения индуцируется органная дисфункция и полиорганная недостаточность.

Заключение

Заключение. Неблагоприятное течение COVID-19 сопровождается многочисленными сбоями механизмов сопряжения сердечного выброса и состояния гемодинамики в сосудах разного калибра и емкости.

In the pathogenesis of the unfavorable course of the new coronavirus infection COVID-19, deviations in the state of blood flow are of significant importance.

Objective

Objective: to compare early changes in the state of blood flow in COVID-19 with the outcome of the disease.

Materials and research methods. In 55 patients with severe COVID-19 in the early respiratory phase, a simultaneous study of the state of macrohemodynamics was carried out using a non-invasive method of volumetric compression oscillometry and microcirculation using an mDLS sensor (Dynamic Light Scattering, Rehovot, Israel). Subsequently, a group of patients (36 people), who were discharged from the hospital in connection with recovery, and a group of patients (19 people), whose disease ended in death, were identified.

Results

Results. In the COVID-19 group with a favorable outcome, the mean blood pressure, pulse blood pressure velocity, heart rate and pulse wave velocity were higher. At the same time, in deceased patients, the hemodynamic index of the axial high-frequency flow of the microcirculation system sharply decreased. The revealed deviations in the parameters of hemodynamics and microcirculation indicate changes in the state of blood circulation in vessels of different diameters, which is an essential link in the pathogenesis of the severe course of COVID-19. With the progression of circulatory failure, organ dysfunction and multiple organ failure are induced.

Conclusion

Conclusion. The unfavorable course of COVID-19 is accompanied by numerous failures of the mechanisms of conjugation of cardiac output and the state of hemodynamics in vessels of different caliber and capacity.

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The authors declare that there are no conflicts of interest present.