A possible new diagnostic approach to Long COVID.
Long COVID may involve microcirculatory blockages - tiny, persistent clots known as fibrinaloid microclots.
These abnormal fibrin structures resist breakdown and can obstruct blood flow in the smallest vessels.🧵
Long COVID may involve microcirculatory blockages - tiny, persistent clots known as fibrinaloid microclots.
These abnormal fibrin structures resist breakdown and can obstruct blood flow in the smallest vessels.🧵
https://twitter.com/dbkell/status/1979116689733165258
The result - local hypoxia, fatigue, muscle weakness, brain fog - classic long COVID symptoms.
Even a slight obstruction means tissues aren’t getting enough oxygen.
Even a slight obstruction means tissues aren’t getting enough oxygen.
A new preprint study by Kell & Pretorius proposes a non-invasive diagnostic tool -
thermal imaging (IR thermography) - using skin temperature patterns to visualize microcirculatory dysfunction.
thermal imaging (IR thermography) - using skin temperature patterns to visualize microcirculatory dysfunction.
Cooler areas = reduced blood flow (microcirculatory deficit).
Warmer areas - may show inflammation or compensatory hyperperfusion.
Together, they form a thermal fingerprint of endothelial dysfunction.
Warmer areas - may show inflammation or compensatory hyperperfusion.
Together, they form a thermal fingerprint of endothelial dysfunction.
Why it matters.
Low-cost (even smartphone-compatible), non-invasive, repeatable, useful for tracking recovery or therapy response
Low-cost (even smartphone-compatible), non-invasive, repeatable, useful for tracking recovery or therapy response
The authors note that thermal imaging could be combined with other biomarkers of inflammation and coagulation to provide a more complete picture of vascular health.
“Before thermal imaging can be widely adopted in the clinic, there is a need for careful protocol standardisation and calibration, along with the creation of large reference datasets to define what constitutes ‘normal’ perfusion.”
Interpretation matters.
Temperature alone doesn’t directly reflect microcirculation - it must be read in context.
They recommend combining IR imaging with
nailfold capillaroscopy
laser speckle or Doppler analysis
biomarkers of endothelial dysfunction (eg von Willebrand factor)
Together, these offer both quantitative and visual insight into microvascular integrity.
Temperature alone doesn’t directly reflect microcirculation - it must be read in context.
They recommend combining IR imaging with
nailfold capillaroscopy
laser speckle or Doppler analysis
biomarkers of endothelial dysfunction (eg von Willebrand factor)
Together, these offer both quantitative and visual insight into microvascular integrity.
Sum:
Thermal imaging can make the invisible visible - revealing microcirculatory blockages in Long COVID as a real fingerprint of endothelial dysfunction and impaired tissue perfusion.
Thermal imaging can make the invisible visible - revealing microcirculatory blockages in Long COVID as a real fingerprint of endothelial dysfunction and impaired tissue perfusion.
This study by Kell & Pretorius is not focused specifically on Long COVID - it explores thermal imaging as a general tool to assess microcirculatory health across many conditions (diabetes, sepsis, vascular disease, etc).
The link to Long COVID is contextual, since fibrinaloid microclots and endothelial dysfunction are shared features across these disorders.
The link to Long COVID is contextual, since fibrinaloid microclots and endothelial dysfunction are shared features across these disorders.
D. Kell, E. Pretorius, Assessing the Health and Functionality of the Microcirculation Using Thermal Imaging. preprints.org/manuscript/202…
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