Saleem, Shafaq, Hussain, Ahmad, Haroon, Muhammad et al. · Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis · 2026 · DOI
This review examined whether a blood test called thromboelastography (TEG) could help diagnose and manage long COVID and ME/CFS by detecting microclots—tiny blood clots thought to persist in these conditions. Studies included in the review reported that microclots are commonly observed in both conditions, and that TEG shows patterns suggestive of altered blood clotting in long COVID patients. However, the review notes that TEG is not yet standardized across laboratories, and treatments targeting microclots (such as certain anticoagulants) still require further testing.
For ME/CFS researchers and patients, this review provides a structured assessment of whether microclot detection and real-time coagulation profiling might offer a pathway toward objective diagnostic markers and targeted treatment in a condition where biomarkers remain contested. The potential applicability of long COVID findings—by analogy—suggests that blood coagulation monitoring could become part of a precision-medicine framework, though clinical translation remains preliminary. Understanding the diagnostic and therapeutic role of TEG may help guide future trial design in ME/CFS.
This systematic review does not establish that microclots cause ME/CFS or long COVID symptoms, only that they are reported as co-occurring. It does not prove that TEG is an effective diagnostic tool in routine clinical practice, as standardization and controlled validation studies are lacking. It does not demonstrate that anticoagulant or fibrinolytic treatments are effective for ME/CFS patients; treatment efficacy claims rest on preliminary or uncontrolled data. The extent to which long COVID findings apply to ME/CFS remains unresolved.
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
Saleem, Shafaq, Hussain, Ahmad, Haroon, Muhammad, Raza, Ahmad, Afzal, Umar, Anwar, Muhammad Furqan, et al. (2026). Dynamic microclot profiling: thromboelastography advances precision management in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. https://doi.org/10.1097/MBC.0000000000001439
BibTeX
@article{mecfsatlas-saleem-2026-dynamic-microclot,
author = {Saleem, Shafaq and Hussain, Ahmad and Haroon, Muhammad and Raza, Ahmad and Afzal, Umar and Anwar, Muhammad Furqan and Imran, Samar and Iqbal, Muhammad Usman and Hajj, Fatima},
title = {Dynamic microclot profiling: thromboelastography advances precision management in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis},
year = {2026},
doi = {10.1097/MBC.0000000000001439},
note = {PubMed: 42274123},
url = {https://www.mecfsatlas.com/evidence/saleem-2026-dynamic-microclot},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-07-08. https://www.mecfsatlas.com/evidence/saleem-2026-dynamic-microclot
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