Endothelial and Autonomic Assessments in the Management of COVID-19

Background: The goal of this peer review is to outline the benefits of the TM Flow system and Lifeprobes Kiosk assessing the endothelial and autonomic system functions in the management of COVID-19 for triage of the patients at risk and diagnostic of autonomic nervous system dysfunction to understand the long COVID symptoms. Material and Methods: The TM Flow system is a non-invasive medical device that relies on pulse oximetry, blood pressure measurements, and very low electrical current stimulation of the skin via disposable electrodes to provide instantaneous assessments of patients’ vital signs, endothelial function, sudomotor and autonomic nervous system functions, and ankle brachial index measurements. The Lifeprobes Kiosk performs automated pre-consultation patient assessments via an online patient check-in form and medical questionnaire, as well as determines the patient’s vital signs, endothelial function markers and estimated body composition. COVID-19: Current Scientific Data: In the majority of cases, COVID-19 infection will manifest through mild to moderate symptoms (such as cough, runny nose, sore throat, headache, muscle aches, and fever) which would resolve without the need for special treatment or hospitalization. On the other hand, older individuals and those who suffer from underlying medical conditions—such as obesity, diabetes, cardiovascular disease, chronic respiratory disease, and/or cancer—are more susceptible to developing serious illness, often with a fatal outcome. Available evidence further indicates that COVID-19 vaccines reduce the number of new cases, while also lessening the risk of complications that would require hospitalization. However, these findings do not apply to the new delta variant, which leads to more severe complications in younger people than previous variants, even in those who have been vaccinated and/or do not have any underlying medical problems. Research conducted to date indicates that COVID-19 complications result from endothelial dysfunction or damage. In addition, COVID-19 patients are increasingly reporting a wide range of debilitating conditions long after they have tested negative for the presence of the virus, giving rise to the term “Long COVID” which has been attributed to autonomic nervous system dysfunction and small fiber neuropathy. TM Flow markers have been investigated by several clinical studies in the US, India, and Brazil. The clinical studies showed the relevance of the TM Flow endothelial and autonomic nervous markers. Conclusion: Findings yielded by peer-reviewed clinical studies confirm that the TM Flow system and Lifeprobes Kiosk are beneficial and effective non-invasive tools that provide immediate results. Therefore, both should be employed for the triage of COVID-19 patients to expediently identify those at risk of complications, as this would reduce the hospitalization and mortality rates. The TM Flow system is also capable of diagnosing “Long COVID” symptoms related to the autonomic nervous system and small fiber neuropathy.