{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T23:48:31Z","timestamp":1776383311414,"version":"3.51.2"},"reference-count":89,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The 2019 novel coronavirus, known as severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19), is causing a global pandemic. The virus primarily affects the upper and lower respiratory tracts and raises the risk of a variety of non-pulmonary consequences, the most severe and possibly fatal of which are cardiovascular problems. Data show that almost one-third of the patients with a moderate or severe form of COVID-19 had preexisting cardiovascular comorbidities such as diabetes mellitus, obesity, hypertension, heart failure, or coronary artery disease. SARS-CoV2 causes hyper inflammation, hypoxia, apoptosis, and a renin\u2013angiotensin system imbalance in a variety of cell types, primarily endothelial cells. Profound endothelial dysfunction associated with COVID-19 can be the cause of impaired organ perfusion that may generate acute myocardial injury, renal failure, and a procoagulant state resulting in thromboembolic events. We discuss the most recent results on the involvement of endothelial dysfunction in the pathogenesis of COVID-19 in patients with cardiometabolic diseases in this review. We also provide insights on treatments that may reduce the severity of this viral infection.<\/jats:p>","DOI":"10.3390\/ijms222111920","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T17:59:38Z","timestamp":1635962378000},"page":"11920","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The Role of Endothelium in COVID-19"],"prefix":"10.3390","volume":"22","author":[{"given":"Mihaela","family":"Ionescu","sequence":"first","affiliation":[{"name":"Cardiology Department, Faculty of Medicine, Ovidius University of Constan\u0163a, 900527 Constan\u0163a, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0555-526X","authenticated-orcid":false,"given":"Anca Pantea","family":"Stoian","sequence":"additional","affiliation":[{"name":"Diabetes, Nutrition, and Metabolic Diseases Department, Faculty of Medicine, Carol Davila University, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9549-8504","authenticated-orcid":false,"given":"Manfredi","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Diabetes, Nutrition, and Metabolic Diseases Department, Faculty of Medicine, Carol Davila University, 050474 Bucharest, Romania"},{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-2112","authenticated-orcid":false,"given":"Dragos","family":"Serban","sequence":"additional","affiliation":[{"name":"Forth Surgery Department, Emergency University Hospital Bucharest and Faculty of Medicine, Carol Davila University, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-417X","authenticated-orcid":false,"given":"Domenico","family":"Nuzzo","sequence":"additional","affiliation":[{"name":"Italian National Research Council, Institute for Research and Biomedical Innovation (CNR-IRIB), 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-4500","authenticated-orcid":false,"given":"Laura","family":"Mazilu","sequence":"additional","affiliation":[{"name":"Oncology Department, Faculty of Medicine, Ovidius University of Constan\u0163a, 900527 Constan\u0163a, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andra Iulia","family":"Suceveanu","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Faculty of Medicine, Ovidius University of Constan\u0163a, 900527 Constan\u0163a, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7474-2395","authenticated-orcid":false,"given":"Ana Maria","family":"Dascalu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Emergency University Hospital Bucharest and Faculty of Medicine, Carol Davila University, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irinel Raluca","family":"Parepa","sequence":"additional","affiliation":[{"name":"Cardiology Department, Faculty of Medicine, Ovidius University of Constan\u0163a, 900527 Constan\u0163a, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s11906-020-01078-6","article-title":"Endothelial Dysfunction in COVID-19: Lessons Learned from Coronaviruses","volume":"22","author":"Gavriilaki","year":"2020","journal-title":"Curr. 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