Transcriptomic profiling of endothelial progenitor cells in post-COVID-19 patients: Insights at 3 and 6-month post-infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused significant global morbidity since 2019. Long COVID, characterized by persistent symptoms after acute infection, may involve endothelial injury. We analyzed endothelial colony-forming cells (ECFCs) from post-COVID-19 patients at 3- and 6-month post-infection, comparing them with healthy controls and stratifying by prior pulmonary embolism (PE). Transcriptomic profiling identified differentially expressed genes (DEGs) associated with endothelial homeostasis, inflammation, oxidative stress, and thrombosis. Post-COVID ECFCs showed downregulation of <i>NOS3</i>, <i>KLF2</i>, <i>ANGPT1</i>, <i>PIK3R3</i>, <i>GBX2</i>, <i>GDF6</i>, <i>SMAD6</i>, <i>SRC</i>, and <i>TGFB1</i>, and upregulation of <i>CASP1</i>, <i>CXCL5</i>, <i>IL12A</i>, <i>SOD2</i>, <i>TIMP3</i>, and <i>TLR2</i>. Minimal differences were observed between 3 and 6-month samples. PE patients showed downregulation of thrombosis-related genes such as <i>PTGS2</i> and <i>ACKR3.</i> These findings indicate sustained endothelial dysfunction and inflammation up to 6 months post-infection, highlighting the importance of long-term monitoring and potential therapeutic strategies to support vascular health in post-COVID-19 patients.