Beyond the Acute Phase: Long-Term Impact of COVID-19 on Functional Capacity and Prothrombotic Risk-A Pilot Study

Area of Science:

• Pulmonology
• Cardiology
• Infectious Diseases

Background:

• Assessing long-term sequelae of COVID-19 is crucial for understanding chronic disease progression.
• Investigating the prothrombotic and proinflammatory status post-COVID-19 infection identifies potential therapeutic targets.

Purpose of the Study:

• To evaluate the chronic proinflammatory, prothrombotic, and functional status in COVID-19 survivors at least two years after acute infection.
• To identify specific parameters with potential therapeutic and prognostic value in post-COVID-19 patients, particularly those with pulmonary fibrosis.

Main Methods:

• Retrospective descriptive study of 117 COVID-19 patients reassessed at least two years post-infection.
• Cohort divided into groups with and without pulmonary fibrosis (diagnosed via high-resolution computed tomography).
• Analysis of inflammatory markers (CRP, WBC, neutrophils, ferritin), prothrombotic markers (D-dimers, MPV), cardiac parameters (heart rate, QT interval), and pulmonary function tests (spirometry, DLCO, 6-minute walk test).

Main Results:

• Patients with pulmonary fibrosis exhibited significantly higher C-reactive protein, white blood cell count, neutrophils, mean platelet volume, lactate dehydrogenase, and D-dimers.
• Elevated D-dimer levels were strongly negatively correlated with diffusion capacity corrected for hemoglobin (DLCO).
• ROC analysis indicated that persistent high D-dimer levels predict low DLCO values (AUC=0.772, p<0.001).

Conclusions:

• COVID-19-related pulmonary fibrosis is associated with a persistent long-term proinflammatory and prothrombotic state, even with functional recovery.
• Elevated D-dimer levels in post-COVID-19 patients may serve as a predictive factor for impaired DLCO.
• These findings highlight the need for continued monitoring and potential interventions for chronic cardiovascular and pulmonary risks in COVID-19 survivors.