{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:18:14Z","timestamp":1790270294110,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Coronavirus disease 2019 (<jats:styled-content style=\"fixed-case\">COVID<\/jats:styled-content>\u201019) has been associated with impaired endothelial and vascular function. We investigated whether intervention with glycocalyx dietary supplement (<jats:styled-content style=\"fixed-case\">GDS<\/jats:styled-content>), containing glucosamine sulfate and fucoidan, improves endothelial glycocalyx and vascular function after <jats:styled-content style=\"fixed-case\">COVID<\/jats:styled-content>\u201019 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010seven convalescent patients 14\u2009days after mild\u2010to\u2010moderate <jats:styled-content style=\"fixed-case\">COVID<\/jats:styled-content>\u201019 infection managed in an outpatient setting were randomized to receive <jats:styled-content style=\"fixed-case\">GDS<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u2009=\u200929) or placebo (<jats:italic>n<\/jats:italic>\u2009=\u200928) for 4 consecutive months. We measured at baseline and at 4\u2009months: (a) perfused boundary region (<jats:styled-content style=\"fixed-case\">PBR<\/jats:styled-content>) of the sublingual microvessels with a diameter range of 4\u201325\u2009\u03bcm, as a marker of endothelial glycocalyx integrity, (b) pulse wave velocity and augmentation index, (c) coronary flow reserve using Doppler echocardiography, and (d) malondialdehyde and protein carbonyls as oxidative stress markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four months after treatment, patients who received <jats:styled-content style=\"fixed-case\">GDS<\/jats:styled-content> showed a greater reduction in <jats:styled-content style=\"fixed-case\">PBR<\/jats:styled-content> 4\u201325\u2009\u03bcm (\u22126.8% vs. \u22121.3%), pulse wave velocity (\u221213.2% vs. \u22123%), augmentation index (\u221228.5% vs. \u22122.5%), malondialdehyde (\u221226% vs. \u22122.9%), protein carbonyls (\u221231.3% vs. \u22121%) and a greater increase in coronary flow reserve (12.9% vs. 1.6%) compared to placebo (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). In the <jats:styled-content style=\"fixed-case\">GDS<\/jats:styled-content> group, the reduction in <jats:styled-content style=\"fixed-case\">PBR<\/jats:styled-content> 4\u201325\u2009\u03bcm was associated with the corresponding decrease in pulse wave velocity (<jats:italic>r<\/jats:italic>\u2009=\u2009.31, <jats:italic>p<\/jats:italic>\u2009=\u2009.047), malondialdehyde, and protein carbonyls, as well as with the increase in coronary flow reserve (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.59, <jats:italic>p<\/jats:italic>\u2009=\u2009.008) at follow\u2010up. Post\u2010treatment, none of the patients under <jats:styled-content style=\"fixed-case\">GDS<\/jats:styled-content> reported post\u2010<jats:styled-content style=\"fixed-case\">COVID<\/jats:styled-content> symptoms compared to 21.4% of the patients under placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Four\u2010month treatment with <jats:styled-content style=\"fixed-case\">GDS<\/jats:styled-content> may improve endothelial glycocalyx and vascular function after <jats:styled-content style=\"fixed-case\">COVID<\/jats:styled-content>\u201019 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>URL: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>. Unique identifier: NCT05185934.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.70058","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T09:04:39Z","timestamp":1745485479000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of 4\u2010month treatment with glycocalyx dietary supplement on endothelial glycocalyx and vascular function after COVID\u201019 infection"],"prefix":"10.1111","volume":"55","author":[{"given":"George","family":"Pavlidis","sequence":"first","affiliation":[{"name":"2nd Department of Cardiology Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Kountouri","sequence":"additional","affiliation":[{"name":"2nd Propaedeutic Department of Internal Medicine, Research Unit and Diabetes Center Attikon University Hospital, 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