Viral Endothelial Dysfunction: A Unifying Mechanism for COVID-19

Megha Prasad, Martin Leon, Lilach O. Lerman, Amir Lerman

Research output: Contribution to journalReview articlepeer-review


The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus with significant global impact, morbidity, and mortality. The SARS-CoV-2 virus may result in widespread organ manifestations including acute respiratory distress syndrome, acute renal failure, thromboembolism, and myocarditis. Virus-induced endothelial injury may cause endothelial activation, increased permeability, inflammation, and immune response and cytokine storm. Endothelial dysfunction is a systemic disorder that is a precursor of atherosclerotic vascular disease that is associated with cardiovascular risk factors and is highly prevalent in patients with atherosclerotic cardiovascular and peripheral disease. Several studies have associated various viral infections including SARS-CoV-2 infection with inflammation, endothelial dysfunction, and subsequent innate immune response and cytokine storm. Noninvasive monitoring of endothelial function and identification of high-risk patients who may require specific therapies may have the potential to improve morbidity and mortality associated with subsequent inflammation, cytokine storm, and multiorgan involvement.

Original languageEnglish (US)
Pages (from-to)3099-3108
Number of pages10
JournalMayo Clinic proceedings
Issue number12
StatePublished - Dec 2021

ASJC Scopus subject areas

  • General Medicine


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