Long-term angiogenic and thromboinflammatory signatures in post-COVID-19 syndrome.

Authors

Arlette Araceli Mora Zetina, Erika Fabiola Ortega Sanchez, Brenda Saraí Zuñiga Ascencio, Armando Roberto Castorena Maldonado, Víctor Hugo Ahumada Topete, Luz María Torres Espíndola, Arnoldo Aquino Gálvez, Rosario Fernández Plata, Anjarath Lorena Higuera Iglesias, David Martínez Briseño, Aranza Bernal Silva, Misael Osmar García Martín, José Eduardo Márquez García, Angelica Moncada Morales, Jaime Chávez Alderete, Rafael Hernandez Zenteno, Eduardo Becerril Vargas, Daniela Josefina Cataneo Piña, José Leopoldo Aguilar Faisal, Jazmín García Machorro, Pedro López Sánchez, María Elena Hernandez Campos, Manuel Castillejos López

Published in

Angiogenesis. Volume 29. Issue 4. Aug 07, 2026. Epub Aug 07, 2026.

Abstract

Post-COVID-19 syndrome is a major long-term sequela of severe SARS-CoV-2 infection, potentially involving persistent angiogenic and thromboinflammatory dysfunction, though long-term biomarker behavior remains unclear.
To evaluate the evolution of angiogenic and thromboinflammatory biomarkers in post-COVID-19 syndrome patients.
This ambispective cohort study was conducted at the National Institute of Respiratory Diseases in Mexico City. Thirty-two adults hospitalized for severe or critical COVID-19 in 2020 were followed for three and a half years. Paired plasma samples were collected during hospitalization and at long-term follow-up. Endothelial dysfunction markers included soluble P-selectin, vascular endothelial growth factor receptor 2, vascular endothelial growth factor D, and angiopoietin-1. Hemostasis was assessed by prothrombin time. Acute-phase proteins alpha-2-macroglobulin and haptoglobin were measured via immunoassay. Persistent symptoms were documented at follow-up.
At three and a half years, persistent symptoms were common: fatigue in sixty-five point 6%, dyspnea in sixty-two point 5%, and concentration difficulties in sixty-five point 6%. Vascular endothelial growth factor D and angiopoietin-1 remained elevated. Alpha-2-macroglobulin stayed high, and prothrombin time was prolonged in a subset of patients.
Severe COVID-19 survivors show sustained angiogenic dysregulation and thromboinflammatory imbalance. Elevated vascular endothelial growth factor D and angiopoietin-1 indicate ongoing angiogenic perturbations, while increased alpha-2-macroglobulin and prolonged prothrombin time reflect persistent coagulation disturbances. These biomarkers may help identify long-term vascular alterations in post-COVID-19 syndrome.

PMID:
42568003
Bibliographic data and abstract were imported from PubMed on 08 Aug 2026.

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