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Microthromboses in Long COVID and Post-Vac Syndrome – What Role Does the Endothelium Play?

04.09.2026

Endotheliitis and Microthromboses – An Important Area of Research in Long COVID

In addition to chronic inflammation, another topic is increasingly moving into the focus of research:

Vascular damage and microthromboses.

Many scientists are currently investigating whether changes in the smallest blood vessels could contribute to the development of various Long COVID symptoms.

What Is the Endothelium?

The endothelium forms the inner lining of all blood vessels.

It performs numerous vital functions:

  • Regulation of blood clotting
  • Control of vascular tone
  • Supply of the organs
  • Protection against inflammation
  • Regulation of blood flow

Even minor damage can have far-reaching effects on the entire organism.

How Could Microthromboses Develop?

Various research groups are discussing several possible mechanisms.

These include, among others:

  • Activation of blood platelets
  • Changes in coagulation
  • Endothelial inflammation
  • Oxidative stress
  • Disorders of fibrinolysis
  • Changes in electrical charge

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  • Scoring of the endothelium by spikes or metallic contents (material abrasion during the manufacturing process of vaccine doses)

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  • Metallic self-organization as transmitter/receiver in blood vessels through possible contents of the injections

These processes could contribute to the formation of the smallest blood clots (microthrombi).

Why Are Microthromboses Relevant?

Microthrombi can block the smallest blood vessels.

As a result, the supply of tissues with oxygen and nutrients is restricted.

This could possibly explain why affected individuals develop symptoms such as:

  • Fatigue
  • Concentration problems
  • Muscle pain
  • Exercise intolerance
  • Breathing difficulties
  • Neurological complaints
  • Visual disturbances (microthrombi)

These relationships are currently being intensively investigated scientifically.

Effects on the Heart and Brain

If larger blood vessels are affected, researchers discuss possible links with:

  • Heart attack
  • Stroke
  • Pulmonary embolism
  • Cardiac arrhythmias
  • Vascular inflammation

Here too, considerable further research is still required.

Modern Diagnostics Are Becoming Increasingly Important

More and more specialists are focusing on:

  • Endothelial function
  • Coagulation diagnostics
  • Microcirculation
  • Inflammatory markers
  • Immune profiles

These examinations could help to better understand Long COVID and Post-Vac Syndrome in the future.

Specialist Knowledge for Doctors and Therapists

The specialist book

Guide to the Diagnosis and Treatment of Post-COVID/Post-Vac Syndrome (Spikeopathy)

provides a comprehensive overview of the scientific literature on inflammatory processes, endothelial damage, microthromboses, diagnostics, and therapeutic approaches.

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