Sustained VWF-ADAMTS-13 Axis Imbalance and Endotheliopathy in Long COVID Syndrome is Related to Immune Dysfunction

Prolonged recovery is common after acute SARS‐CoV‐2 infection; however, the pathophysiological mechanisms underpinning Long COVID syndrome remain unknown. VWF/ADAMTS‐13 imbalance, dysregulated angiogenesis, and immunothrombosis are hallmarks of acute COVID‐19. We hypothesized that VWF/ADAMTS‐13 imbalance persists in convalescence together with endothelial cell (EC) activation and angiogenic disturbance. Additionally, we postulate that ongoing immune cell dysfunction may be linked to sustained EC and coagulation activation.