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Dynamic Coagulation Function Changes in COVID-19 Survivors With Coronary Artery Disease
Jianjun Zhang1, Junqi Yin2, Yucheng Jin2
1Department of Clinical Laboratory, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China.
Summary
Coronary artery disease patients with prior COVID-19 infection show lasting hypercoagulability and high neutrophil levels for two years post-discharge. Standard treatments may not fully resolve this increased clotting risk.
Area of Science:
- Cardiology
- Infectious Diseases
- Hematology
Background:
- Coronary artery disease (CAD) and Coronavirus disease 2019 (COVID-19) independently increase thrombotic risk.
- The long-term interaction between these conditions and post-COVID-19 hypercoagulability in CAD patients is not well understood.
Purpose of the Study:
- To investigate dynamic changes in coagulation function in COVID-19 survivors with CAD over a two-year follow-up.
- To assess the impact of prior COVID-19 infection on hypercoagulability and neutrophil levels in CAD patients.
Main Methods:
- Retrospective analysis of 117 CAD patients (60 COVID-19 positive, 57 controls).
- Thromboelastography (TEG) and conventional coagulation tests performed at admission, and one and two years post-discharge.
- Neutrophil, lymphocyte, and platelet counts monitored.
Main Results:
- COVID-19 survivors showed sustained hypercoagulable TEG profiles (accelerated clot initiation, rapid propagation, enhanced strength) at one and two years post-discharge compared to controls (P < 0.05).
- Conventional coagulation tests did not reveal significant between-group differences.
- Elevated neutrophil levels persisted at one and two years post-discharge in the COVID-19 group (P = 0.0353, P = 0.0397).
- Standard antithrombotic therapy did not fully normalize TEG-defined hypercoagulability.
Conclusions:
- CAD patients with a history of COVID-19 exhibit persistent hypercoagulability and elevated neutrophils up to two years post-discharge.
- TEG monitoring and neutrophil surveillance are crucial for managing these patients.
- Individualized anticoagulation strategies are needed, as standard regimens may be insufficient.
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