Building on the success of COVID-19 Related Acute Vascular Distress Syndrome: from Physiopathology to Treatment, we are pleased to relaunch Volume II of this Research Topic.

The COVID-19 pandemic hit the world at end of 2019. More than a year after, the world is still struggling with three million deaths. From our early experience, we suggested that COVID-19 disease is a vascular disease and that the lung is probably more sensitive than other organs. This hypothesis led us to introduce in April 2020 the acronym “AVDS” for Acute Vascular Distress Syndrome. This acronym seems to be more appropriate for COVID-19 than the usual ARDS (acute respiratory distress syndrome) acronym.

At the lung level, the disease seems to be characterized, at any stage, by an increased pulmonary blood flow with an intrapulmonary right-to-left shunt. At the cellular level, vascular endothelialitis has been described. At the organ level, some authors described impairment of microcirculation and neoangiogenesis. These phenomena highly participate to the unusual presentation of COVID-19 pulmonary disease: from the “happy hypoxemia” phenomenon to the heterogenous response to prone positioning. Moreover, intravascular thrombosis due to unexpected alteration of fibrinolysis is responsible for high incidence of pulmonary embolism and impairment of other organs. It also seems that other organ vessels as heart, kidney or brain are targeted by the virus.

In this Research Topic, we aim to welcome the submission of high-quality papers of all types that focuses on the vascular component of COVID-19. Thus, the aim of this Research Topic is an attempt to extensively describe and investigate the COVID-19 related AVDS.

Welcome topics include but are not limited to:

• biochemical and cellular mechanisms,

• microcirculatory patterns

• vascular thrombosis

• vasculature imaging

• specific clinical finding

• effect of previous therapies

• effect of new therapies

• prophylaxis of thrombosis/vascular occlusion and its efficiency.

These topics may be extended to all organs targeted by the virus as far as the vascular component is concerned. This collection will help clinicians and researchers from all over the world to focus on the real victim of SARS-COV-2: the human vessel.

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