Journal of Bioequivalence & Bioavailability

Abstract

Long COVID in pediatric and young adult patients: a review of evaluation for microvascular changes, endothelial dysfunction, and arterial stiffness

Kazumi Fujioka*

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) reservoirs in most tissues may be underlying endotheliitis in Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). The vascular changes of the microcirculation with persistent capillary rarefication and endothelial dysfunction have already been demonstrated in adult patients with PASC. In this review, the author outlined the current knowledge and trends of long COVID-19 for evaluation of microvascular changes, endothelial dysfunction and arterial stiffness in pediatric and young adult patients. The Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed and Excerpta Medica dataBASE (EMBASE) data-bases were systematically searched for studies using microvascular, endothelial, and Arterial Stiffness (AS) dysfunction in pediatric and young adult patients with long COVID. In addition, the therapeutic strategies for long COVID patients have been also described. Based on the evidence, Nailfold Videocapillaroscopy (NVC) may demonstrate microvascular injury such as capillary dilatations in adult patients with long COVID. The increased arterial stiffness may lead to atherosclerosis status, increased vascular aging, Cardiovascular Disease (CVD) risks, and CV complications in pediatric and young adult patients with long COVID. As the increasing AS may tend to cause the hypertension and atherosclerotic condition in the long term in pediatric and young long COVID patients, therefore it is emphasized that the comprehensive follows-up for early onset of atherosclerosis condition is essential. Further investigations are needed to clarify the outcomes.

Published Date: 2026-10-05; Received Date: 2026-09-05