An Interesting Case of Long Covid Vasculitis

Atluri Venkata Abhinav, Rajeswari Sankaralingam, Sudagar Singh, Divya Yanamadala, Nidhi Prabhu

Abstract: SARS-CoV-2 virus was first identified in 2019 and affected approximately 775 million people worldwide1. COVID-19 can cause many complications, and one of the rarest and least known is large vessel vasculitis involving the aorta and myocardium. Few cases are reported with aortitis, but involvement of the myocardium is very rare. The pathophysiological observations in post-COVID-19 vasculitis have been studied2, and certain observations have been made. SARS-CoV-2 infects the host organs, including the lung, heart, kidney, and intestine, using the angiotensin-converting enzyme 2 (ACE2) receptor. These ACE2 receptors are expressed in endothelial cells, as known by previous COVID-19 studies. Aortic endothelium, largely provided with angiotensin-converting enzyme-2 receptors, is directly attacked by virions, leading to an endotheliitis that could later be complicated by hypersensitive vasculitis.

Keywords: COVID-19 vasculitis, large vessel vasculitis, post-COVID complications, ACE2 receptor pathology, myocardial aortitis