ENDOTHELIAL DYSFUNCTION AND IMMUNE–FIBROTIC CROSSTALK AS CENTRAL DRIVERS OF POST-COVID PROGRESSION IN RHEUMATIC DISEASES

Endothelial dysfunction has emerged as one of the most consistent and clinically significant consequences of COVID-19, persisting well beyond viral clearance. The vascular endothelium plays a pivotal role in immune regulation, tissue perfusion, and connective tissue homeostasis. In rheumatic diseases—including ankylosing spondylitis, rheumatoid arthritis, reactive arthritis, osteoarthritis, allergic vasculitis, and systemic sclerosis—endothelial impairment represents a shared pathogenic pathway that contributes to chronic inflammation, fibrosis, and joint destruction.