Microvascular Dysfunction in COVID-19 Patients: MYSTIC Study

Microvascular dysfunction in COVID-19

Microvascular Dysfunction in COVID-19 Patients: MYSTIC Study

Angiogenesis volume 24, pages 145–157 (2021)

Research reveals that COVID-19 patients have severe damage to microcirculation and the endothelial glycocalyx. The data in a newly released study clearly show severe reduction of microcirculation and the endothelial glycocalyx in patients with COVID-19 and underscores the importance of healthy microcirculation and capillaries.

The study’s finding has fueled the hypothesis that COVID-19 is actually a vascular illness and that systemic leakiness and impairment of the endothelial glycocalyx might play a central role in the development of acute respiratory distress syndrome (ARDS) and multi-organ failure.

Capillaries are lined with a gel-like lining called the endothelial glycocalyx, and when they are in good health the glycocalyx enables delivery of essential oxygen and nutrients to all vital organs. When microcirculation is severely impaired, as is the case for critically ill COVID-19 patients, lung function is significantly reduced, and mechanical ventilation is required for them to breathe.

The study was overseen by University Hospital Munster in Germany and compared three groups:

1) COVID-19 patients without need for mechanical ventilation

2) COVID-19 patients requiring mechanical ventilation

3) Control group of healthy people.

The study reveals:

  • Up to 95% of the smallest capillaries —the tiniest part of microcirculation—have been severely damaged in patients on mechanical ventilators. For perspective, about 100 capillaries would fit inside a human hair.
  • Up to 65% of the smallest capillaries have been severely damaged in patients who aren’t on ventilation.

With such a large percentage of the smallest capillaries having been severely damaged, oxygen cannot be transported from the lungs to the rest of the body.

This study was possible because of GlycoCheck, a new ground-breaking medical device from Microvascular Health Solutions. GlycoCheck testing is non-invasive. A video microscope camera is placed under the tongue where microvessels are representative of the entire body. In just minutes, 100,000 vessels are measured, with 1,000 measurements calculated per vessel. There are over 100 million calculations from the test.

The GlycoCheck test measures the interaction of red blood cells with the surface of the endothelial glycocalyx, expressed as the perfused boundary region (PBR). Increases in PBR reflect damage to the glycocalyx and this parameter was developed by Dr. Hans Vink, PhD, a glycocalyx research pioneer on the team who has studied the glycocalyx for more than three decades. Dr. Vink considers PBR to be the “canary in the coal mine” that reveals if the glycocalyx has become thin and damaged.

GlycoCheck combines the PBR measurement with density of capillaries, and capillary recruitment capacity, which is how capillary density increases at higher levels of blood flow. Together, these three measurements analyze microvascular health and objectively report a single systemic MicroVascular Health Score™.

The glycocalyx becomes damaged because of several risk factors such as aging, genetics, obesity, stress, pollution, smoking, and vaping. Researchers in hospitals worldwide are using GlycoCheck technology to link a damaged glycocalyx with heart disease, kidney disease, stroke, hypertension, diabetes, and other conditions. With the publication of this ground-breaking study, we now know COVID-19 can also be linked to a severely damaged glycocalyx.

Endothelial glycocalyx research using GlycoCheck is being conducted by more than 90 hospitals in Africa, Asia, Australia, China, Europe, Japan, Russia, and the United States. Most recently, GlycoCheck has been recognized by MedTech Outlook as one of the Top 10 Breakthrough Medical Testing Devices for 2020.