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Vascular "Long COVID": A New Vessel Disease?
Giada Zanini1, Valentina Selleri1,2, Luca Roncati3
1Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Angiology
|January 18, 2023
Summary
Long Covid (LC) involves vascular issues like endotheliitis and vasculitis developing 12 weeks post-COVID-19. Understanding these SARS-CoV-2-related vascular pathologies is crucial for effective LC treatment.
Area of Science:
- Vascular biology
- Infectious disease pathology
- Immunology
Background:
- Long Covid (LC) encompasses vascular sequelae manifesting over 12 weeks after SARS-CoV-2 infection.
- Existing data on LC vascular complications is limited.
- Pathophysiological mechanisms from the acute SARS-CoV-2 infection offer insights into LC vascular disease.
Purpose of the Study:
- To elucidate the vascular pathologies associated with Long Covid (LC).
- To translate understanding of SARS-CoV-2 infection mechanisms to LC vascular complications.
- To inform clinical management by recognizing vascular issues as potential LC manifestations.
Main Methods:
- Review and synthesis of pathophysiological mechanisms of SARS-CoV-2 infection.
- Extrapolation of microcirculatory and macrocirculatory changes observed in acute COVID-19 to LC.
- Analysis of immune and pro-coagulant dysregulation in SARS-CoV-2 infection.
Main Results:
- Microcirculatory system: Endotheliitis, Neutrophil Extracellular Trap (NET) formation, evolving into leukocytoclastic-like and hyperimmune vasculitis.
- Medium/large vessels: Endothelial dysfunction, accelerated atherosclerosis via platelet and inflammatory cell deposition.
- Systemic effects: Dysregulated immunity and pro-coagulant states leading to thrombo-embolic events.
Conclusions:
- Vascular pathologies are a significant component of Long Covid (LC).
- Mechanisms include endotheliitis, vasculitis, endothelial dysfunction, and pro-thrombotic states.
- Clinical recognition of these vascular issues is essential for appropriate LC patient management.
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