Endothelial dysfunction is an important mechanism underlying multiple organ and systems failure in COVID-19. The development of endothelial dysfunction in COVID-19 can disrupt organ perfusion and cause a procoagulant state, leading to both macro- and microvascular thrombotic events. Cognitive impairment is a common complication of COVID-19 that develop in acute and delayed periods and is not directly related to the severity of the underlying disease. Treatment of endothelial dysfunction in patients with COVID-19 should take into account the leading pathogenetic factors of its development and with the development of neurological, including cognitive, disorders should include neuroprotective drugs. One of these drugs is actovegin, which has been shown to be effective in improving endothelial function, microcirculation and cognition.