Dynamic coagulation function changes in COVID-19 survivors with coronary artery disease

Coronary artery disease (CAD) and Coronavirus disease 2019 (COVID-19) are both associated with a hypercoagulable state. This study investigates the dynamic changes in coagulation function among COVID-19 survivors with CAD over a two-year follow-up period. A total of 117 CAD patients admitted to Shanghai Pudong Hospital between March and June 2021 were included, with 60 patients who had COVID-19 infection forming the COVID-19 group and 57 patients without COVID-19 forming the control group. Thromboelastography (TEG) and conventional coagulation tests were performed at admission and at one and two years after discharge. Correlation analyses were conducted to explore the relationship between TEG parameters and clinical data.Results showed that at one and two years after discharge, the COVID-19 group exhibited significantly shorter reaction time (R) and K time (K), as well as higher maximum amplitude (MA), α-angle, and coagulation index (CI) compared to the control group (P < 0.05), indicating a more hypercoagulable state. However, no significant differences were observed in conventional coagulation parameters (P > 0.05). Neutrophil levels in the COVID-19 group were significantly elevated at one and two years after discharge (P = 0.0353 and P = 0.0397, respectively) and were positively correlated with MA (P = 0.0231 and P = 0.0209, respectively).In conclusion, CAD patients with COVID-19 infection demonstrated sustained hypercoagulability and elevated neutrophil levels up to two years after discharge, which may contribute to their enhanced coagulation function. These findings highlight the importance of monitoring coagulation status and neutrophil levels in CAD patients recovering from COVID-19 and suggest the need for targeted anticoagulation strategies. Future research should focus on validating these findings in larger, multicenter cohorts and exploring the underlying mechanisms and potential therapeutic targets.