{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:22:04Z","timestamp":1784542924574,"version":"3.55.0"},"reference-count":60,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T00:00:00Z","timestamp":1703635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: 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. Materials and Methods: 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 (n = 49) or absence (n = 68) of pulmonary fibrosis, documented through high-resolution computer tomography. Results: The cohort comprises 117 patients, 69.23% females, with a mean age of 65.74 \u00b1 10.19 years and abnormal body mass index (31.42 \u00b1 5.71 kg\/m2). Patients with pulmonary fibrosis have significantly higher levels of C-reactive protein (CRP) (p &lt; 0.05), WBC (7.45 \u00b1 7.86\/mm3 vs. 9.18 \u00b1 17.24\/mm3, p = 0.053), neutrophils (4.68 \u00b1 7.88\/mm3 vs. 9.07 \u00b1 17.44\/mm3, p &lt; 0.05), mean platelet volume (MPV) (7.22 \u00b1 0.93 vs. 10.25 \u00b1 0.86 fL, p &lt; 0.05), lactate dehydrogenase (p &lt; 0.05), and D-dimers (p &lt; 0.05), but not ferritin (p = 0.470), reflecting the chronic proinflammatory and prothrombotic status. Additionally, patients with associated pulmonary fibrosis had a higher mean heart rate (p &lt; 0.05) and corrected QT interval (p &lt; 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, p &lt; 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. Conclusions: 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.<\/jats:p>","DOI":"10.3390\/medicina60010051","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T09:56:27Z","timestamp":1703757387000},"page":"51","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Beyond the Acute Phase: Long-Term Impact of COVID-19 on Functional Capacity and Prothrombotic Risk\u2014A Pilot Study"],"prefix":"10.3390","volume":"60","author":[{"given":"Doina-Clementina","family":"Cojocaru","sequence":"first","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1801-9327","authenticated-orcid":false,"given":"Florin","family":"Mitu","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"},{"name":"Academy of Medical Sciences, 030167 Bucharest, Romania"},{"name":"Academy of Romanian Scientists, 700050 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Magdalena","family":"Leon","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia Corina","family":"Dima-Cozma","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-3320","authenticated-orcid":false,"given":"Cristina Andreea","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2564-537X","authenticated-orcid":false,"given":"Carmen Marinela","family":"Cump\u0103t","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Negru","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-9696","authenticated-orcid":false,"given":"Alexandra","family":"Ma\u0219taleru","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"Clinical Rehabilitation Hospital, Cardiovascular and Respiratory Rehabilitation Clinic, Pantelimon Halipa Street No. 14, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2762-0918","authenticated-orcid":false,"given":"Viviana","family":"Onofrei","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties I and III, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania"},{"name":"\u201cSt. Spiridon\u201d Clinical Emergency Hospital, Cardiology Department Independence Boulevard No. 1, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,27]]},"reference":[{"key":"ref_1","first-page":"2000178","article-title":"First Cases of Coronavirus Disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020","volume":"25","author":"Spiteri","year":"2020","journal-title":"Euro Surveill. Bull. Eur. Sur Mal. Transm. Eur. Commun. Dis. Bull."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1117464","DOI":"10.3389\/fimmu.2023.1117464","article-title":"Long COVID: A Review and Proposed Visualization of the Complexity of Long COVID","volume":"14","author":"Perumal","year":"2023","journal-title":"Front. 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