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Persistent endothelial dysfunction in post-COVID-19 syndrome and its associations with symptom severity and chronic inflammation


Senior Member
This is a very long paper.

The most important part:


PCS patients with CFS exhibited a more severely impaired retinal microvascular integrity in our cohort. Even though this association was weaker after controlling for confounders, this aligns with recent findings describing ED in PCS patients with additional CFS [46] and patients with CFS independently of SARS-CoV-2 infection [51, 52]. Besides SARS-CoV-2, many viruses are known to infect endothelial cells and trigger endotheliitis, and post-viral fatigue is causally attributed more and more to ED [53].

The mechanisms that underlie ongoing inflammation in PCS patients are not fully clear. Autoimmunity, the persistence of the virus, and virus reactivation in patients have been discussed and could explain persistent ED in PCS patients [54,55,56,57]. Induction of autoimmunity after viral infections is not specific to SARS-CoV-2 and has been described in Epstein-Barr virus (EBV), cytomegalovirus, and many more [58].