D-Dimer and Coagulation profile are significant prognostic indicators in COVID-19 patients – A retrospective study in a tertiary healthcare hospital

Authors : Kolla Vinod, Sivasankari R, Abhishek Uday Kumar, Manjari Rajagopalan, Georgin Shahji

DOI : 10.18231/j.ijirm.2021.041

Volume : 6

Issue : 3

Year : 2021

Page No : 188-195

Background:  To determine the value of coagulation indicators: D-dimer (DD), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), in predicting the severity and prognosis of COVID-19.
Materials and Methods:  Around 150 patients with confirmed COVID-19 disease, who were admitted at Rajarajeswari Medical College and Hospital, Bangalore between April 15 2021 and July 15, 2021, were included in the study. The changes of D-Dimer, PT, APTT were tested, and the correlation with, clinical classifications, demographics, CT imaging, vaccination status against COVID-19 and prognosis were observed.
Results:  Coagulation disorder occurred at the early stage of COVID-19 infection, in a total of 150 patients observed, 109 (72.66%, St. deviation of 4.26) patients having DD increased at time of admission and 148 patients (98.66%) having increased coagulation profile. The levels of DD and coagulation profile were correlated with clinical classification and also the CT severity and vaccination status. Among 41(27.33%) patients who died, 31(20.66%) patients had DD increased at the first lab test, 40 (26.66%) patients had DD increased on the fifth day of lab tests. The results shows that D-dimer is raised in severe category of COVID-19 infection. Also the CT severity is high (severe, with CT score>15) 71(47.33%) patients with increased D-dimer on admission. It was observed that 41(27.33%) patients who were vaccinated had increased D-dimer 70(46.66%) compared to unvaccinated patients. In addition, with the progression of the disease, the change of CT imaging was closely related to the increase of the DD value (P <0> Conclusions:  Coagulation dysfunction is more likely to occur in severe and critically ill patients. DD and PT could be used as the significant indicators in predicting the mortality of COVID-19 and measuring the level of D-dimer and coagulation parameters from the early stage of the disease can also be useful in controlling and managing of COVID-19 disease, also vaccinated patients had better outcome among the unvaccinated patients.
 
Keywords: DD­ D dimer, PT­ prothrombin time, aPTT­ activated partial thromboplastin time


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