Jones, Ansley E, Mira-Sanchez, Margarita, Khan, Zain et al. · Journal of intensive care medicine · 2026 · DOI
This study examined blood clotting patterns in 93 people who survived severe COVID-19 requiring hospitalization, testing them 15 months after discharge. Researchers observed that those with lingering post-COVID symptoms—particularly fatigue and post-exertional malaise (worsening after activity)—showed altered clotting characteristics on specialized blood tests, specifically higher fibrinogen levels. However, this is a single cross-sectional study and does not establish whether these clotting changes cause the symptoms or are simply associated with them.
By analogy, if similar clotting alterations are present in ME/CFS (where post-exertional malaise is a cardinal feature), understanding fibrinogen-driven hypercoagulability might inform investigation of shared pathophysiological pathways. The association between clotting markers and PEM—a symptom pattern also seen in ME/CFS—may suggest a testable mechanistic target, though relevance to primary ME/CFS remains unclear and would require prospective study in ME/CFS cohorts.
This cross-sectional design does not establish that clotting abnormalities cause PASC symptoms; temporal direction and causation cannot be inferred. It does not demonstrate that these findings apply to ME/CFS, which has a different etiology and disease history. It does not evaluate whether correcting clotting abnormalities would improve symptoms, nor does it rule out reverse causality or unmeasured confounding.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Jones, Ansley E, Mira-Sanchez, Margarita, Khan, Zain, McGroder, Claire F, Depender, Christopher, Ogunlusi, Charity O, et al. (2026). Subclinical Hypercoagulable Viscoelastic Characteristics Associated with Post-Acute Sequelae of SARS-CoV2 Physical Symptoms in COVID-19 ALI/ARDS Survivors.. Journal of intensive care medicine. https://doi.org/10.1177/08850666261453886
BibTeX
@article{mecfsatlas-jones-2026-subclinical-hypercoagulable,
author = {Jones, Ansley E and Mira-Sanchez, Margarita and Khan, Zain and McGroder, Claire F and Depender, Christopher and Ogunlusi, Charity O and Murphy, Scarlett O and Wei, Ying and Garcia, Christine K and Roh, David J and Baldwin, Matthew R},
title = {Subclinical Hypercoagulable Viscoelastic Characteristics Associated with Post-Acute Sequelae of SARS-CoV2 Physical Symptoms in COVID-19 ALI/ARDS Survivors.},
journal = {Journal of intensive care medicine},
year = {2026},
doi = {10.1177/08850666261453886},
note = {PubMed: 42200676},
url = {https://www.mecfsatlas.com/evidence/jones-2026-subclinical-hypercoagulable},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/jones-2026-subclinical-hypercoagulable
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