Introduction. Post-COVID syndrome (PCS) is associated with persistent dysfunction of the coagulation system, which is often latent and cannot be verified by standard coagulation tests. Therefore, adequate risk stratification requires a transition to integrated methods for assessing thrombin potential in combination with standard tests, which will allow personalization of antithrombotic prophylaxis strategies during the rehabilitation period in patients who have recovered from COVID-19. Aim. To evaluate the parameters of the thrombin generation test (TGT) and D-dimer level in patients with a history of COVID-19. Materials and methods. The study included 80 patients with a history of COVID-19, examined 6 months after recovery. At the time of the study, all patients were receiving clinically selected therapy according to their comorbidities. The control group consisted of 68 healthy individuals without cardiovascular diseases, thromboembolic complications, or a history of COVID-19 at the time of inclusion. In patients who had recovered from COVID-19 (6 months after recovery) and in control subjects, the thrombin generation test (TGT) was performed using an automatic Ceveron-alpha coagulometer, and D-dimer levels were measured using an ERBA ECL 412 coagulometer. Additionally, D-dimer levels were analyzed in patients during the acute phase of COVID-19. Results. Six months after COVID-19, patients showed a statistically significant decrease in thrombin generation test (TGT) values compared to the control group, primarily due to the use of direct oral anticoagulants (DOACs). No significant differences in any TGT parameters were found between patients who had severe and moderate forms of the disease. D-dimer levels six months after recovery were significantly higher than during the acute phase. Conclusion. The study confirms that post-COVID syndrome is associated with prolonged activation of the hemostatic system, characterized by an increase in D-dimer concentrations by the sixth month of observation compared to the acute phase of the disease. The absence of a statistically significant correlation between baseline and current values of this marker indicates the independent nature of delayed fibrinolytic impairments, likely due to persistent endothelial dysfunction rather than the severity of primary coagulopathy. At the same time, an integrated assessment of the hemostatic system using a thrombin generation test allows for the evaluation of the effectiveness of anticoagulant therapy.
Maria V. Khimina – specialist of the Department of Laboratory Medicine with Clinic, Almazov National Medical Research Centre, Saint-Petersburg, Russia.
Olga V. Sirotkina – D. Sci. (Biol.), Professor of Department of Laboratory Medicine with Clinic, Almazov National Medical Research Centre, Saint-Petersburg, Russia; Leading Researcher of the Laboratory of Human Molecular Genetics, Petersburg Nuclear Physics Institute named by B.P. Konstantinov of National Research Centre ‘Kurchatov Institute’, Gatchina, Russia.
Yuliya I. Karpova – PhD (Med.), MD, Associate Professor of Department of Laboratory Medicine with Clinic, Almazov National Medical Research Centre, Saint-Petersburg, Russia.
Ekaterina A. Zolotova – PhD (Med.), MD, Assistant of Department of Laboratory Medicine with Clinic, Almazov National Medical Research Centre, Saint-Petersburg, Russia.
Tatyana V. Vavilova – D.Sci.(Med.), Professor, Head of Department of Laboratory Medicine with Clinic, Almazov National Medical Research Centre, Saint-Petersburg, Russia.
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