Long COVID Atlas › Glossary › Endothelial dysfunction
MechanismEndothelial dysfunction
https://longcovidatlas.org/glossary/endothelial-dysfunction
In plain language
What it is
When the vessel lining stops working properly, so vessels constrict, leak, or signal inflammation when they should not.
Why it matters
It is a leading explanation for breathlessness with normal scans, raised clotting, and higher heart risk after COVID.
Think of it like
The smart hose coating is still there, but its controls are off: it tightens when it should relax and leaks when it should seal.
For specialists
Formal definition
A shift of the endothelium toward a vasoconstrictive, pro-inflammatory, and pro-thrombotic state with reduced nitric oxide bioavailability and impaired flow-mediated dilation.
Mechanism
Spike-ACE2 interaction, persistent antigen, and immune activation drive senescence, leukocyte adhesion, tissue-factor expression, and barrier breakdown.
Scientific consensus
Impaired vascular function is measurable in long COVID and ME/CFS cohorts and tracks with symptom severity.
Active debate
How much is driven by persistent virus versus autoimmunity versus microclots remains unsettled.
Sources
- Clinical implications of COVID-19-related endothelial dysfunction free full text ›