Endothelial dysfunction in COVID-19 patients assessed with Endo-PAT2000

It has been widely reported that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) attaches human cells by using the Angiotensin Converting Enzyme 2 (ACE2) receptor [1], which is expressed in several organs, including the endothelial cells [2]. Whether vascular impairment described during coronavirus disease 2019 (COVID-19) infection is primarily due to the direct involvement of the endothelial cells by the virus or secondarily to the inflammatory host response is currently unknown, but there is evidence that SARS-CoV-2 can directly infect human blood vessel [3)]. Recently, Varga and colleagues, described autopsy findings from three patients who died from COVID-19, showing direct viral infection of the endothelium systemic and endotheliitis with proliferation of lymphocytes and macrophages, and loss of integrity of the endothelial monolayer [4]. These patients, however, were affected by concomitant cardiovascular disease such as hypertension, diabetes, obesity, and coronary artery disease, underlying a potential pre-existing endothelial dysfunction.