A Role for the Vascular Endothelium in Post–Acute COVID-19?
Laura de Rooij, Lisa M. Becker, Peter Carmeliet
Abstract
hile the war against acute coronavirus disease 2019 (COVID-19) is still raging, reports of a long-lasting post-COVID-19 syndrome are surging. "Long COVID" progressed from a mere oddity to an acknowledged public health issue worldwide. A formal definition of post-acute COVID-19 syndrome (ie, long COVID) is evolving, and for the purposes of this review, we consider it as persistent symptoms or complications lasting more than 30 days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Symptoms of long COVID involve multiple organs and include shortness of breath, fatigue, chest pain, loss of taste and/or smell, and cognitive dysfunction. Studies investigating the incidence of long COVID report broad heterogeneity (likely attributable to variations in study cohorts and long COVID definition/symptoms), and its manifestation may range from 30% to a staggering 80% of all SARS-CoV-2infected patients. Although there is hope that vaccination may reduce the risk of developing long COVID, studies remain inconclusive thus far. Breakthrough infections frequently occur in vaccinated people and may unfortunately still cause an escalation in long COVID cases. Detection and treatment of long COVID is challenging because the molecular underpinnings of the condition remain largely unknown.