The Corona virus disease 2019 (Covid-19) has brought a wide range of challenges in intensive care medicine. Understanding of the pathophysiology of Covid-19 relies on interpreting of its impact on the vascular, particularly microcirculatory system. Herein we report on the first use of the latest generation hand-held vital microscope to evaluate the sublingual microcirculation in a Covid-19 patient with subcutaneous emphysema, venous thrombosis and pneumomediastinum. Remarkably, microcirculatory parameters of the patient were increased during the exacerbation period, which is not a usual finding in critically ill patients mostly presenting with a loss of hemodynamic coherence. In contrast, recovery from the disease led to a subsequent amelioration of these parameters. This report clearly shows the importance of microcirculatory monitoring for evaluating the course and the adequacy of therapy in Covid-19 patients.

COVID-19, IDF imaging, pneumomediastinum, subcutaneous emphysema, sublingual microcirculation, venous thrombosis,
Frontiers in Medicine
Department of Intensive Care

Grewal, S. (Sanjeev), Harjo, B. (Brita), Aykut, G. (Güclü), Ergin, B, Nowitzky, R. (Ralph), Ince, C. (Can), & Akin, S. (2021). Case Report: Sublingual Microcirculatory Alterations in a Covid-19 Patient With Subcutaneous Emphysema, Venous Thrombosis, and Pneumomediastinum. Frontiers in Medicine, 7. doi:10.3389/fmed.2020.624695