{
  "abstract": "Background: Coronavirus disease 2019 (COVID-19) is characterized by inflammation-driven endothelial dysfunction and coagulation abnormalities that become increasingly prominent with disease severity. Although prolonged prothrombin time (PT) is consistently associated with adverse outcomes in hospitalized patients, its behavior in mild COVID-19 remains poorly defined. Establishing whether PT reflects early hemostatic activation in non-severe disease is essential for appropriate laboratory interpretation and clinical decision-making. Objectives: To critically synthesize the available evidence on PT behavior in adults with mild COVID-19 and discuss its laboratory and clinical implications. Methods: An integrative review was conducted according to the Whittemore and Knafl framework and reported in accordance with the PRISMA 2020 statement. PubMed/MEDLINE was systematically searched for observational studies published between January 2020 and November 2025 evaluating PT (seconds, activity, or international normalized ratio [INR]) in adults with mild COVID-19. Studies involving pediatric or pregnant populations, animal models, reviews, editorials, case reports, or lacking PT-specific data were excluded. Forty-two records were identified, 19 underwent full-text review, and 14 met the eligibility criteria for qualitative synthesis. Results: The included studies originated from Asia, Europe, Africa, and South America and predominantly comprised retrospective hospital-based cohorts. Notably, none of the included studies was specifically designed to investigate PT exclusively in patients with mild COVID-19, highlighting a major gap in the current evidence. Despite methodological heterogeneity in disease severity definitions, timing of blood sampling, and PT reporting, findings were highly consistent. Across studies, PT values generally remained within reference ranges among patients with mild COVID-19, whereas observed variations were minimal, inconsistent, and without independent clinical or prognostic significance. In contrast, PT prolongation was consistently associated with moderate-to-severe COVID-19, intensive care unit admission, and adverse clinical outcomes, indicating that PT abnormalities are more likely to reflect progressive systemic inflammation, endothelial injury, and coagulation dysregulation rather than early hemostatic disturbances. Conclusions: Current evidence does not support the use of PT as a standalone biomarker of hemostatic impairment in mild COVID-19. The preservation of PT across available studies suggests that the extrinsic coagulation pathway remains largely intact during early-stage disease, whereas clinically meaningful abnormalities emerge with increasing severity. The lack of studies specifically designed to investigate mild COVID-19 represents a major knowledge gap and underscores the need for well-designed prospective studies in outpatient populations to define the temporal dynamics of PT and clarify its potential prognostic utility. Keywords: COVID-19; Prothrombin Time; Hemostasis; Blood Coagulation; Biomarkers.",
  "abstract_shown": true,
  "affiliations": [
    "Universidade Federal Fluminense (UFF), Niterói, Brazil",
    "Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil",
    "Universidade Federal Fluminense (UFF), Niterói, Brazil; Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Érica De Cássia SILVA"
    },
    {
      "affs": [
        0
      ],
      "name": "Lívia Ferreira de SOUSA"
    },
    {
      "affs": [
        1
      ],
      "name": "Juliana Britto Martins de OLIVEIRA"
    },
    {
      "affs": [
        0
      ],
      "name": "Mariana Ferreira FIGUEIREDO"
    },
    {
      "affs": [
        0
      ],
      "name": "Cláudia Rezende Vieira de Mendonça SOUZA"
    },
    {
      "affs": [
        0
      ],
      "name": "Thiago Pavoni Gomes CHAGAS"
    },
    {
      "affs": [
        0
      ],
      "name": "Isabela Resende PEREIRA"
    },
    {
      "affs": [
        2
      ],
      "name": "Andrezza Do Espirito Santo CUCINELLI"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9nsqbgfjbfn74.bib",
  "cited_by": 0,
  "doi": "10.1016/j.htct.2026.108039",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2531137926017864",
  "id": "9nsqbgfjbfn74",
  "issns": [
    "2531-1379",
    "2531-1387"
  ],
  "landing_url": "https://doi.org/10.1016/j.htct.2026.108039",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC633-647.5"
    ],
    [
      "openalex",
      "2725|COVID-19 Clinical Research Studies"
    ]
  ],
  "openalex": "W7223112405",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/9nsqbgfjbfn74.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:43:37Z",
      "native_id": "d14ff5d3bd2c402dab314676de91a5cf",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.htct.2026.108039"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|COVID-19 Clinical Research Studies",
      "subfield": "infectious-disease"
    }
  ],
  "title": "PROTHROMBIN TIME IN MILD COVID-19: CURRENT EVIDENCE AND IMPLICATIONS FOR LABORATORY PRACTICE",
  "title_text": "PROTHROMBIN TIME IN MILD COVID-19: CURRENT EVIDENCE AND IMPLICATIONS FOR LABORATORY PRACTICE",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:37Z",
  "url": "https://research.draconitic.com/paper/9nsqbgfjbfn74",
  "venue": "Hematology, Transfusion and Cell Therapy",
  "versions": []
}