Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches. Review uri icon

Overview

abstract

  • SARS-CoV-2-infected individuals may suffer a multi-organ system disorder known as "long COVID" or post-acute sequelae of SARS-CoV-2 infection (PASC). There are no standard treatments, the pathophysiology is unknown, and incidence varies by clinical phenotype. Acute COVID-19 correlates with biomarkers of systemic inflammation, hypercoagulability, and comorbidities that are less prominent in PASC. Macrovessel thrombosis, a hallmark of acute COVID-19, is less frequent in PASC. Female sex at birth is associated with reduced risk for acute COVID-19 progression, but with increased risk of PASC. Persistent microvascular endotheliopathy associated with cryptic SARS-CoV-2 tissue reservoirs has been implicated in PASC pathology. Autoantibodies, localized inflammation, and reactivation of latent pathogens may also be involved, potentially leading to microvascular thrombosis, as documented in multiple PASC tissues. Diagnostic assays illuminating possible therapeutic targets are discussed.

publication date

  • August 1, 2022

Research

keywords

  • COVID-19
  • Thrombosis

Identity

Digital Object Identifier (DOI)

  • 10.1172/JCI161167

PubMed ID

  • 35912863

Additional Document Info

volume

  • 132

issue

  • 15