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Introduction Vascular injury and inflammation are hallmarks of acute COVID-19, but their link to patient-reported outcomes remains unclear. This study examined associations between biomarkers of endothelial activation, haemostasis and quality of life and physical function post-hospitalisation.Methods In a prospective, multicentre study, previously hospitalised COVID-19 patients and seronegative controls with similar characteristics were assessed at enrolment (the time of hospital discharge) and convalescence (28-60 days). Blood samples measured haemostasis and vascular injury markers. Patient-reported outcomes included EQ-5D, Patient Health Questionnaire-4 (PHQ-4), the Brief Illness Perception Questionnaire, the International Physical Activity Questionnaire (IPAQ), and the Duke Activity Status Index (DASI). Associations were assessed using Spearman’s correlation. A two-sided p-value of less than 0.05 was considered statistically significant.Results COVID-19 (n=202) and control (n=20) group participants were similar in age (56.0 ± 9.0 vs. 54.6 ± 12.0 years, p = 0.567), sex (40.0% vs. 41.3% female, p = 1.000), and BMI (30.2 ± 5.1 vs. 31.0 ± 7.0 kg/m 2, p = 0.577). At enrolment COVID-19 patients had elevated D-dimer (196 vs. 75 ng/ml, p = 0.003), fibrinogen (3.5 vs. 3.0 g/L, p = 0.006), factor VIII (167 vs. 104 IU/dL, p < 0.001), vWF:GP1bR (212 vs. 128, p < 0.001), vWF:Ag (220 vs. 159, p = 0.002), ICAM-1 (594 vs. 396 ng/ml, p < 0.001), and VCAM-1 (1210 vs. 667 ng/ml, p < 0.001). At enrolment, D-dimer correlated negatively with IPAQ METs (r = -0.342, p < 0.001) and DASI (r = -0.317, p < 0.001); factor VIII had similar associations and was additionally linked to PHQ-4 depression (r = 0.157, p = 0.014). VCAM-1 correlated negatively with EQ-5D VAS (r = -0.207, p = 0.001), IPAQ (r = -0.307, p < 0.001), and DASI (r = -0.292, p < 0.001).At follow-up, factor VIII had the most consistent correlations, being negatively associated with EQ-5D Health Utility (r = -0.273, p < 0.001) and DASI (r = -0.273, p < 0.001), while positively correlating with Brief Illness Perception (r = 0.244, p = 0.001) and PHQ-4 Depression (r = 0.181, p = 0.018). ICAM-1 and VCAM-1, markers of endothelial activation, were negatively correlated with EQ-5D Health Utility (ICAM-1: r = -0.183, p = 0.016; VCAM-1: r = -0.215, p = 0.005) and EQ-5D VAS (ICAM-1: r = -0.179, p = 0.019; VCAM-1: r = -0.203, p = 0.007), while positively associated with PHQ-4 Total (ICAM-1: r = 0.152, p = 0.049; VCAM-1: r = 0.135, p = 0.081), suggesting a link between endothelial dysfunction and poorer perceived health during recovery.Sensitivity analysis excluding participants on aspirin or oral anticoagulation were similar.Conclusion Endothelial activation and haemostasis biomarkers are associated with impairments in physical function and quality of life in COVID-19 survivors, indicating vascular injury may contribute to persistent symptoms and represent potential therapeutic targets for Long COVID.