Evidence map›Paper›PMID 42333348›Full record

ArticleCureus2026

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

Rama Krishna Prasad Chikkala, Sandeep Garre, A Chaitanya Pratyusha, Syama Sundar Ayya, Kalyani Sangineni, Sneha Gogula

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rama Krishna Prasad ChikkalaAnaesthesiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
Sandeep GarreAnaesthesiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
A Chaitanya PratyushaAnaesthesiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
Syama Sundar AyyaAnaesthesiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
Kalyani SangineniAnaesthesiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
Sneha GogulaAnaesthesiology, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background The long-term sequelae of COVID-19, collectively termed long COVID, manifest as persistent symptoms that may be driven by ongoing coagulation abnormalities. Early identification, particularly in primary care, requires simple, low-cost tools that do not rely on advanced diagnostics. This study evaluated the usefulness of basic coagulation markers and the Six-Minute Walk Test (6MWT) in assessing symptom severity and functional limitation among individuals with long COVID. Methodology A two-phase observational study was conducted from July 2022 to January 2024. Phase I enrolled 197 adults more than six weeks post-COVID-19 who presented with fatigue, breathlessness, reduced exercise tolerance, cough, or musculoskeletal pain. Baseline investigations included C-reactive protein (CRP), prothrombin time (PT)/international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, and platelet count, alongside the 6MWT. The primary objective was to evaluate the association between coagulation abnormalities and the severity of long COVID symptoms. Secondary objectives included assessment of functional impairment using the 6MWT and evaluation of persistence of coagulation abnormalities at the three-month follow-up. Patients with abnormal baseline coagulation or inflammatory parameters (n = 63) underwent repeat evaluation after three months. Results The study included 197 participants with a mean age of 37.3 ± 11.97 years, of whom 87 (44.2%) were male. Reduced effort tolerance was the most common presenting symptom, observed in 151 (76.7%) patients. At baseline, abnormalities were noted in D-dimer (50 (25.4%)), fibrinogen (43 (21.8%)), CRP (34 (17.3%)), aPTT (23 (11.7%)), PT/INR (21 (10.7%)), and platelet count (10 (5.1%)). Patients with severe symptoms demonstrated significantly higher levels of D-dimer and fibrinogen (p < 0.001 for both). Elevated D-dimer (50 (25.4%)) and fibrinogen (43 (21.8%)) were associated with an increased risk of severe symptomatology, with relative risks of 3.0 and 2.34, respectively. At the three-month follow-up, persistent elevation of D-dimer (32 (50.8%)) and fibrinogen (30 (47.6%)) was observed, indicating sustained coagulation abnormalities in a substantial subset of individuals with long COVID. Conclusions This study demonstrates a significant association between elevated D-dimer and fibrinogen levels and symptom severity in patients with long COVID. Simple, accessible tools, particularly basic coagulation tests and the 6MWT, may serve as useful adjunctive assessments for primary care physicians to identify long COVID patients with probable ongoing thrombo-inflammatory activity. Integrating these assessments into routine follow-up may improve early detection, monitoring, and targeted referral.

Indexed as

6-minute walk testcoagulationd-dimerfibrinogenlong covidpost-covid sequelae

Identifiers

PMID42333348
PMCPMC13283287

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.