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

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 1; p. 51
• Main Authors: Cojocaru, Doina-Clementina, Mitu, Florin, Leon, Maria-Magdalena, Dima-Cozma, Lucia Corina, Adam, Cristina Andreea, Cumpăt, Carmen Marinela, Negru, Robert D, Maștaleru, Alexandra, Onofrei, Viviana
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-01-2024
• Subjects: Aged; Ambulatory Care Facilities; body plethysmography; Cholesterol; Chronic obstructive pulmonary disease; Coronaviruses; COVID-19; COVID-19 - complications; Creatinine; D-dimers; Dyspnea; Female; Ferritin; functional capacity; Glycosylated hemoglobin; Heart beat; Hospitals; Humans; Infections; long COVID; Male; Middle Aged; Pilot Projects; prothrombotic risk; Pulmonary Fibrosis; Pulmonary function tests; Rehabilitation; Retrospective Studies; Spirometry; Thrombosis; Romania; COVID-19; D-dimers; functional capacity; DLCO; body plethysmography; prothrombotic risk; long COVID
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60010051

: Assessment of the prothrombotic, proinflammatory, and functional status of a cohort of COVID-19 patients at least two years after the acute infection to identify parameters with potential therapeutic and prognostic value.
: We conducted a retrospective, descriptive study that included 117 consecutive patients admitted to Iasi Pulmonary Rehabilitation Clinic for reassessment and a rehabilitation program at least two years after a COVID-19 infection. The cohort was divided into two groups based on the presence (
= 49) or absence (
= 68) of pulmonary fibrosis, documented through high-resolution computer tomography.
: The cohort comprises 117 patients, 69.23% females, with a mean age of 65.74 ± 10.19 years and abnormal body mass index (31.42 ± 5.71 kg/m
). Patients with pulmonary fibrosis have significantly higher levels of C-reactive protein (CRP) (
< 0.05), WBC (7.45 ± 7.86/mm
vs. 9.18 ± 17.24/mm
,
= 0.053), neutrophils (4.68 ± 7.88/mm
vs. 9.07 ± 17.44/mm
,
< 0.05), mean platelet volume (MPV) (7.22 ± 0.93 vs. 10.25 ± 0.86 fL,
< 0.05), lactate dehydrogenase (
< 0.05), and D-dimers (
< 0.05), but not ferritin (
= 0.470), reflecting the chronic proinflammatory and prothrombotic status. Additionally, patients with associated pulmonary fibrosis had a higher mean heart rate (
< 0.05) and corrected QT interval (
< 0.05). D-dimers were strongly and negatively correlated with diffusion capacity corrected for hemoglobin (DLCO corr), and ROC analysis showed that the persistence of high D-dimers values is a predictor for low DLCO values (ROC analysis: area under the curve of 0.772,
< 0.001). The results of pulmonary function tests (spirometry, body plethysmography) and the 6-minute walk test demonstrated no significant difference between groups, without notable impairment within either group.
Patients with COVID-19-related pulmonary fibrosis have a persistent long-term proinflammatory, prothrombotic status, despite the functional recovery. The persistence of elevated D-dimer levels could emerge as a predictive factor associated with impaired DLCO.