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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.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|August 6, 2026
PubMed

Insights

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.

Keywords:
COVID-19coagulation functioncoronary artery disease

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