Persistent Endotheliopathy in the Pathogenesis of Long COVID Syndrome: COMMENT from von Meijenfeldt et al.

To the Editor: With great interest we read the recent brief report by dr. Fogarty and colleagues providing evidence for persistent endothelial cell activation in convalescent COVID-19 patients [1]. The authors showed that plasma levels of von Willebrand factor (VWF), factor VIII, and soluble thrombomodulin were elevated at a median of 68 days after initial COVID-19 symptom resolution or discharge from the hospital. Interestingly, not all these patients experienced severe disease. Levels of endothelial injury markers were associated with long-term symptoms, including dyspnoea, fatigue and concentration impairment, often referred to as long COVID.