Study of microcirculation and the scheduling of rehabilitation measures in children who have recovered from coronavirus disease 2019
Authors:   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Mikheeva I.G. , Kurasova O.B. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Milekhina M.Yu. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Moiseev A.B. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Kuznetsova N.I. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Kalinovskaya I.I. ,   Children Bronchopulmonary Sanitarium, Moscow, Russian Federation, Zimina N.A. ,   Children Bronchopulmonary Sanitarium, Moscow, Russian Federation, Vereshchagina T.G. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation
Published: June 2024

Aim: to analyze microcirculation in children who recovered from coronavirus disease 2019 (COVID-19) in order to identify microcirculatory disorders and their association with clinical symptoms and to design rehabilitation measures Patients and Methods: the study included 78 children aged 7–15 years who recovered from COVID-19. All children had negative SARS- CoV-2 RNA tests (oropharyngeal and naso-pharyngeal swabs) by PCR and positive blood SARS-CoV-2 immunoglobulin class G (IgG). The control group included 30 healthy age-matched children who did not experience COVID-19. Microcirculation was evaluated by slit lamp biomicroscopy for imaging bulbar conjunctival microvasculature with further morphometric processing of images. Exclusion criteria included inflammatory eye diseases, acute bronchopulmonary diseases or their exacerbation, arterial hy-pertension, and obesity grades 2 to 4. Results: a decrease in the count of capillaries, pre- and postcapillaries, and 1 st-order ar-terioles, as well as a decrease in the percentage of 1st-order arterioles were identified in indi-viduals who had been asymptomatic or had experienced mild COVID-19 symptoms 3 to 12 months prior. Additionally, an increase in the count of 1st-order venules and arteriolar venular anastomoses, 2nd-order arterioles and venules, and 1st-order arteries and veins was revealed. The coefficient of irregularity in venular caliber in severe cases of COVID-19 was 0.62±0.05, which was significantly (p<0.023) greater than that in asymptomatic cases of COVID-19 (0.43±0.03). This indicates a persistent reduction in venous tone Conclusions: our study demonstrated microvascular disorders in children in the long-term period following COVID-19, indicating a long-term maladaptation of microcirculation These children can be classified as belonging to the risk group for microcirculatory disorders in the post- COVID period. KEYWORDS: children, COVID-19, long COVID, microvasculature, capillaries, venules, arterioles, microcirculation. FOR CITATION: Mikheeva I.G., Kurasova O.B., Milekhina M.Yu., Moiseev A.B., Kuznetsova N.I., Kalinovskaya I.I., Zimina N.A., Vereshchagina T.G. Study of microcirculation and the scheduling of rehabilitation measures in children who have recovered from coronavirus disease 2019. Russian Journal of Woman and Child Health. 2024;7(2):171–176 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-13.