{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:19:02Z","timestamp":1793755142183,"version":"4.6.1"},"reference-count":137,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"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>Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated not only with respiratory illness but also with profound vascular and coagulation disturbances. Long COVID (LC) is characterized by persistent symptoms such as fatigue, dyspnea, cognitive impairment, and palpitations. Mechanistically, SARS-CoV-2 induces direct endothelial injury, promotes a pro-inflammatory cytokine milieu, and activates platelets, leading to immunothrombosis and impaired fibrinolysis. Consequently, patients exhibit microthrombosis, elevated plasma D-dimer, fibrinogen dysregulation, and persistent hypercoagulability. Clinically, this translates into an increased risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism, as well as arterial thrombotic events such as myocardial infarction and stroke, which may persist months after acute infection. Understanding the interplay between endothelial injury, inflammation, and coagulation is crucial for risk stratification and the development of preventive and therapeutic strategies. We conducted a systematic narrative review of the literature, including human clinical and mechanistic studies identified through PubMed, Scopus and Web of Science up to 30 September 2025. This review synthesizes current evidence on vascular complications in LC, highlighting endothelial dysfunction as a central pathophysiological nexus linking the acute phase of SARS-CoV-2 infection with chronic LC manifestations.<\/jats:p>","DOI":"10.3390\/ijms27010433","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:08:00Z","timestamp":1767197280000},"page":"433","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Vascular Complications of Long COVID\u2014From Endothelial Dysfunction to Systemic Thrombosis: A Systematic Review"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8595-0854","authenticated-orcid":false,"given":"Maja","family":"Stojanovic","sequence":"first","affiliation":[{"name":"Clinic for Anesthesiology and Intensive Care, Institute for Cardiovascular Disease, 11030 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8432-9887","authenticated-orcid":false,"given":"Marko","family":"Djuric","sequence":"additional","affiliation":[{"name":"Clinic for Anesthesiology and Intensive Care, University Clinical Hospital Center \u201cDr Dragisa Misovic-Dedinje\u201d, 11030 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7852-9949","authenticated-orcid":false,"given":"Irina","family":"Nenadic","sequence":"additional","affiliation":[{"name":"Clinic for Anesthesiology and Intensive Care, University Clinical Hospital Center \u201cDr Dragisa Misovic-Dedinje\u201d, 11030 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2938-9585","authenticated-orcid":false,"given":"Suzana","family":"Bojic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Clinic for Anesthesiology and Intensive Care, University Clinical Hospital Center \u201cDr Dragisa Misovic-Dedinje\u201d, 11030 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Andrijevic","sequence":"additional","affiliation":[{"name":"Clinic for Anesthesiology and Intensive Care, Institute for Cardiovascular Disease, 11030 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksa","family":"Popovic","sequence":"additional","affiliation":[{"name":"Clinic for Vascular Surgery, Institute for Cardiovascular Disease, 11030 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3219-1396","authenticated-orcid":false,"given":"Slobodan","family":"Pesic","sequence":"additional","affiliation":[{"name":"Clinic for Vascular Surgery, Institute for Cardiovascular Disease, 11030 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024). 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