Exploring Coagulation Abnormalities and Functional Impairment in Long COVID: Relevance to Primary Care Practice

Area of Science:

• Medical research
• Clinical diagnostics
• Pulmonology

Background:

• Long COVID, a post-viral syndrome, presents persistent symptoms potentially linked to ongoing coagulation abnormalities.
• Early identification in primary care necessitates simple, cost-effective diagnostic tools.
• This study assesses basic coagulation markers and the Six-Minute Walk Test (6MWT) for long COVID evaluation.

Purpose of the Study:

• To evaluate the association between coagulation abnormalities and long COVID symptom severity.
• To assess functional impairment using the 6MWT in long COVID patients.
• To determine the persistence of coagulation abnormalities at three-month follow-up.

Main Methods:

• An observational study involving 197 adults over six weeks post-COVID-19.
• Baseline assessments included C-reactive protein (CRP), prothrombin time (PT)/international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, platelet count, and the 6MWT.
• Patients with abnormal parameters (n=63) were re-evaluated at three months.

Main Results:

• Reduced effort tolerance was the most common symptom (76.7%).
• Baseline abnormalities included D-dimer (25.4%), fibrinogen (21.8%), and CRP (17.3%).
• Elevated D-dimer and fibrinogen significantly correlated with severe symptoms (p < 0.001) and showed persistent elevation at three months in 50.8% and 47.6% of patients, respectively.

Conclusions:

• Significant association exists between elevated D-dimer/fibrinogen and long COVID symptom severity.
• Basic coagulation tests and the 6MWT are valuable adjunctive tools for primary care physicians.
• These accessible assessments can aid in identifying patients with probable ongoing thrombo-inflammatory activity for timely referral and management.