Long COVID: pathophysiological factors and abnormalities of coagulation

Simone Turner, M. Asad Khan, David Putrino, Ashley Woodcock, Douglas B. Kell, Etheresia Pretorius

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Acute COVID-19 infection is followed by prolonged symptoms in approximately one in ten cases: known as Long COVID. The disease affects ~65 million individuals worldwide. Many pathophysiological processes appear to underlie Long COVID, including viral factors (persistence, reactivation, and bacteriophagic action of SARS CoV-2); host factors (chronic inflammation, metabolic and endocrine dysregulation, immune dysregulation, and autoimmunity); and downstream impacts (tissue damage from the initial infection, tissue hypoxia, host dysbiosis, and autonomic nervous system dysfunction). These mechanisms culminate in the long-term persistence of the disorder characterized by a thrombotic endothelialitis, endothelial inflammation, hyperactivated platelets, and fibrinaloid microclots. These abnormalities of blood vessels and coagulation affect every organ system and represent a unifying pathway for the various symptoms of Long COVID.

Original languageEnglish
Pages (from-to)321-344
Number of pages24
JournalTrends in Endocrinology and Metabolism
Issue number6
StatePublished - Jun 2023


  • cardiovascular outcomes
  • clotting pathology
  • endothelialitis
  • long COVID


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