scholarly journals Biochemical and haematological parameters predicting severity of Covid 19 infection: Lessons from first wave of pandemic

2021 ◽  
Vol 8 (3) ◽  
pp. 327-333
Author(s):  
Shweta D Agrawal ◽  
Mrunal Kesari ◽  
Yoganand V Patil ◽  
Harshad V Kesari ◽  
Priyanka V Gadge ◽  
...  
Keyword(s):  
Virus Disease ◽  
Wave Pattern ◽  
Treatment Modalities ◽  
Cross Sectional ◽  
Laboratory Parameters ◽  
Neutrophil Lymphocyte Ratio ◽  
Significant Difference ◽  
Wbc Count ◽  
Monitor Treatment Response ◽  
D Dimer

Corona virus disease 2019 (COVID-19) was declared as pandemic by WHO on March 10, 2020. Several countries around the globe have seen a two-wave pattern of reported cases. India is witnessing unprecedented spike in COVID-19 cases again since March 2021 especially in Maharashtra. Newer insights in pathogenesis of diseases, diagnosis and treatment modalities continue to evolve in case of novel infection. To study and compare laboratory parameters in COVID cases in first wave in 2020. Retrospective cross-sectional observational study. Total 400 cases; 354 RTPCR and 46 RAT confirmed cases of COVID-19 done at dedicated COVID Hospital. Comparison of laboratory parameters was done between 72 Severe and 328 Non-Severe cases by unpaired t-test. Statistically significant differences were seen in severe cases as compared to non severe cases in Lymphocyte count, Eosinophil count, Neutrophil Lymphocyte Ratio, CRP, D-dimer, Ferritin levels. WBC count, Platelet count and ALT did not show significant difference between severe and non severe cases. Lymphopenia, raised N/L ratio, Eosinopenia, increased D-dimer, Ferritin, CRP are associated with severe COVID disease. The routine laboratory tests can diagnose the disease, predict prognosis and complications and monitor treatment response.

scholarly journals OP0313 PRELIMINARY CRITERIA FOR MACROPHAGE ACTIVATION SYNDROME ASSOCIATED WITH CORONAVIRUS DISEASE-19

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 191.1-192
Author(s):  
S. Amikishiyev ◽  
M. G. Gunver ◽  
M. Bektas ◽  
S. Aghamuradov ◽  
B. Ince ◽  
...  
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Laboratory Data ◽  
Disease Onset ◽  
Dynamic Changes ◽  
Ferritin Concentration ◽  
Neutrophil Lymphocyte Ratio ◽  
Significant Difference ◽  
D Dimer ◽  
Activation Syndrome

Background:COVID-19 runs a severe disease associated with acute respiratory distress syndrome in a subset of patients, and a hyperinflammatory response developing in the second week contributes to the worse outcome. Inflammatory features are mostly compatible with macrophage activation syndrome (MAS) observed in other viral infections despite resulting in milder changes. Early detection and treatment of MAS may be associated with a better outcome. However, available criteria for MAS associated with other causes have not been helpful.Objectives:To identify distinct features of MAS associated with COVID-19 using a large database enabling to assess of dynamic changes.Methods:PCR-confirmed hospitalized COVID-19 patients followed between March and September 2020 constituted the discovery set. Patients considered to have findings of MAS by experienced physicians and given anakinra or tocilizumab were classified as the MAS group and the remaining patients as the non-MAS group. The MAS group was then re-grouped as the cases with exact-MAS and borderline-MAS cases by the study group. Clinical and laboratory data including the Ct values of the PCR test were obtained from the database, and dynamic changes were evaluated especially for the first 14 days of the hospitalization. The second set of 162 patients followed between September-December 2020 were used as the replication group to test the preliminary criteria. In the second set, hospitalization rules were changed, and all patients required oxygen support and received dexamethasone 6mg/day or equivalent glucocorticoids. Daily changes were calculated for the laboratory items in MAS, borderline, and non-MAS groups to see the days differentiating the groups, and ROC curves and lower and upper limits (10-90%) of the selected parameters were calculated to determine the cutoff values.Results:A total of 769 PCR-confirmed hospitalized patients were analysed, and 77 of them were classified as MAS and 83 as borderline MAS patients. There was no statistically significant difference in the baseline viral loads of MAS patients compared to the non-MAS group according to the Ct values. Daily dynamic changes in the MAS group differed from the non-MAS group especially around the 6th day of hospitalization, and more than a twofold increase in ferritin and a 1.5-fold increase in D-dimer levels compared to the baseline values help to define the MAS group. Twelve items selected for the criteria are given in Table 1 below. The total score of 45 provided 79.6% sensitivity for the MAS (including borderline cases) and 81.3% specificity around days 5 and 6 in the discovery set, and a score of 60 increased the specificity to 94.9% despite a decrease in sensitivity to 40.8%. The same set provided a similar sensitivity (80.3%) in the replication, but a lower specificity (47.4-66% on days 6 to 9) due to a group of control patients with findings of MAS possibly masked by glucocorticoids.Table 1.Preliminary Criteria for Macrophage Activation Syndrome Associated with Coronavirus Disease-191.Fever (>37.0 °C)2.Ferritin concentration > 550 ng/mL3.More than 2 times increase of ferritin concentration within 7 days of disease onset4.Neutrophil count > 6000 cell/mm35.Lymphopenia < 1000 cell/mm36.Neutrophil/lymphocyte ratio > 67.D-dimer concentration > 1000 ng/ml8.More than 50% increase of D-dimer concentration within 7 days of disease onset9.CRP concetration > 50 mg/L10.LDH concentration > 300 U/L11.ALT or AST concentration > 50 U/L12.Procalcitonin concentration < 1.21 point for each positive item assessed on Days 5-7Score calculation: Total points / 12 x 100Possible MAS ≥45 and Definite MAS ≥60Conclusion:This study defined a set of preliminary criteria using the most relevant items of MAS according to the dynamic changes in the parameters in a group of COVID-19 patients. A score of 45 would be helpful to define a possible MAS group with reasonable sensitivity and specificity to start necessary treatments as early as possible.Disclosure of Interests:None declared.

scholarly journals Clinical Profile and Outcome of COVID Positive Hematology Patients during the COVID-19 Pandemic - an Analytical Cross Sectional Study from a Tertiary Care Centre in India

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4996-4996
Author(s):  
Faisal Kassim ◽  
Chirag Sunil Lalwani ◽  
Hamsini Movva ◽  
Sani Kodathumuriyil Sunny ◽  
Merlin Moni ◽  
...  
Keyword(s):  
Active Treatment ◽  
Conflicts Of Interest ◽  
Tertiary Care ◽  
Outcome Variable ◽  
Categorical Variables ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hematological Diseases ◽  
Significant Difference ◽  
D Dimer

Abstract Introduction: The COVID-19 pandemic is a global public health challenge that has affected more than 30 million people and taken more than 4 lakh lives in India. The first and second COVID waves have greatly impacted the lives of a vast majority and vaccination of the masses remains a struggle. Although SARS -CoV-2 infections in patients with hematological diseases are expected to have an adverse outcomes, only limited reports are available from India. Hence, our study aims to identify the outcome in terms of severity and mortality in this group and the risk factors involved in developing severe COVID-19 and death. Methodology: This is a cross sectional analytical study done in a tertiary care hospital in Southern India for a period of 11 months. All hematological patients irrespective of age, who were infected with SARS-CoV-2 during the first wave (June -December 2020) and second wave (March - June 2021) were consecutively enrolled for the study after IRB approval. The patients were then categorized as neoplastic (acute and chronic leukemia, lymphoma, myeloma, MPN and MDS ) and non-neoplastic (ITP, aplastic anemia, hemolytic anemia, MGUS and TTP ) diseases. The clinical data was collected retrospectively from the electronic medical records and by direct telephonic contact. Patients were categorized as having mild (spO2 &gt; 94 % symptomatic /asymptomatic), moderate (spO2 90 - 94 %) and severe (spO2 &lt; 90 %) disease based on their severity of infection, each category of patients received appropriate clinical management. Treatment details, mortality and other outcomes were recorded for 30 days. The continuous variables were represented as mean (± SD)/median (IQR) and categorical variables as frequency and percentage. The association of the outcome variable with selected variables were calculated using Chi-square tests and kaplan meier survival analysis. The data sets were analyzed (SPSS version 21) and a p value of &lt; 0.05 was considered statistically significant. Results: The study was conducted with 70 patients (n=70). Demographic details of patients are summarized in Table 1.Seventeen (24.3%) out of 49 (70%) hospitalized patients required ICU care. There were 13 (18.6%)deaths. in the patients who survived, prolonged antigen positivity of COVID on testing after 21 days was seen in 9 patients (16.1%). In 35 patients (50%)hematological treatment was restarted with a mean delay of 9.2 +/- 10.72 days. Predictors of severity of the disease is summarized in Table 2. Age more than 50 years (P=0.002)(Figure 1a), severe COVID (P=&lt;0.001) and D dimer value of &gt;2 times normal (P=0.047) were associated with a 30-day mortality. Additionally, patients on active treatment for hematological disease were at greater risk of severe COVID (P=0.012). There was no significant difference in severity (P=0.197) or mortality (P=0.556)in patients with neoplastic vs. non-neoplastic disorders Conclusion: COVID-19 patients with malignant and non-malignant hematological diseases showed an increased mortality. Age &gt; 50 years and high D dimer values (&gt;2N) were identified as predictors of mortality. Active treatment for haematological disease predisposed to severe disease.The study needs to be validated further on a larger cohort of patients . Preventive strategies including vaccination is warranted in patients with hematological disorders. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Correlations of complete blood count, liver enzyme and serum uric Acid in Sudanese pre-eclamptic cases

2018 ◽  
Vol 7 (4) ◽  
pp. 1308
Author(s):  
Hind M. Beheiry ◽  
Ibrahim A. Ali ◽  
Mazin S. Abdalla ◽  
Ahmed M. Sharif ◽  
Amal M. Saeed
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Liver Enzymes ◽  
Complete Blood Count ◽  
Maternity Hospital ◽  
Prognostic Indicators ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean ◽  
Wbc Count

Background: Pre-eclampsia is a serious disorder of pregnancy with unknown ethological factors that may occur at any stage of second or third trimester of pregnancy. The objectives of the present study were to assess changes in complete blood counts including platelets, liver enzymes and serum uric acid in pre-eclamptic cases compared to second-half normal pregnant and non-pregnant Sudanese women and their correlations to other biomarkers.Methods: This was a cross-sectional, case-control study performed from December 2008 to December 2010; in Omdurman Maternity Hospital, in concomitance with other studies in pre-eclampsia. The sample size included three groups, 72 up pre-eclamptic cases in their recent pregnancies, 96 normal pregnant in their second half of pregnancy and 63 non- pregnant (control) women; a total of 231 subjects. Questionnaire Interviews and clinical examination were done for all participants. Laboratory investigations were done including complete blood picture, liver enzymes and uric acid.  Results: The mean Hb concentration of the pre-eclamptic (11.3g/dl±1.7) was statistically significantly lower than that of the non-pregnant (12.1g/dl±0.2) (P=0.01) but not from that of the normal pregnant (11.4g/dl±0.1) (P=0.882) .There was no statistical significant difference in the mean WBC count between the pre-eclamptic (7.4x103/mm3±0.3) and non-pregnant (7.3x103/mm3±0.3) (P=0.797) and between the pre-eclamptic and normal pregnant (7.7x103/mm3±0.2) (P=0.270). There was a considerable statistical significant decrease in the mean platelets count of the pre-eclamptic (236.4/mm3±8.3) compared to the non-pregnant group (322.0/mm3±10.4) (P=0.0001) s well as to the normal pregnant (275.0/mm3±8.9) (P = 0.003). In the pre-eclamptic cases, serum ALT correlated significantly with TWCC (r=0.26, P=0.03) and serum AST (r=0.65, P=0.000). In the pre-eclamptic cases, serum AST correlated significantly with Hb (r=0.26, P=0.03), serum ALT and serum uric acid (r=0.36, P=0.01).Conclusions: There was a considerable statistical significant decrease in mean platelets count of the pre-eclamptic compared to the non-pregnant group and to the normal pregnant may be explained by hemodilution; whereas further decrease was due to pre-eclampsia. ALT and AST are strong prognostic indicators of pre-eclampsia.

scholarly journals PERBEDAAN RERATA FAKTOR HEMOSTASIS PADA PEB, EKLAMPSIA DAN KEHAMILAN NORMAL

2019 ◽  
Vol 3 (1) ◽  
pp. 27-36
Author(s):  
Yogi Syofyan ◽  
Joserizal Serudji ◽  
Hafni Bachtiar
Keyword(s):  
Normal Pregnancy ◽  
Cross Sectional Study ◽  
Severe Preeclampsia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Organs ◽  
Significant Difference ◽  
Keywords Pregnancy ◽  
Post Hoc ◽  
D Dimer

There will be multiple organs changes in preeclampsia and eclampsia. One of them is a change in hemostasis system which is platelet activation, extrinsic and intrinsic cascade reaction and increasing of fibrinolytic activation. This is a cross sectional study conducted at Obstetric and Gynecologic Departement of Medical Faculty of Andalas University/ M Djamil Central Hospital in Padang on July 2014 with the number of samples are 44 persons. Samples are divided into 3 groups: Severe preeclampsia, eclampsia, and normal pregnancy. Platelet, PT,APTT, and D-Dimer counting were conducted and statistic analyzed was done with Anova dan Post Hoc Bonferoni. The more severe pregnancy, the lower platelet count and PT, but the dif- ference is not statistically significant between three groups: severe preeclampsia, eclampsia, and normal pregnancy (p < 0,05). Mean of APTT and D-Dimer is statistically significant due to condition of pregnancy. Post Hoc Bonferroni analysis showed a significant difference of APTT mean in the eclampsia, severe pre-eclampsia, and normal pregnancy (p <0,05 ). D-Dimer Mean shows a significant difference between normal pregnancy, severe preeclampsia, and eclampsia (p <0,05).Keywords: Pregnancy condition, severe preeclampsia, eclampsia, normal pregnancy, platelet, PT, APTT, and D-Dimer

scholarly journals Inflammatory laboratory findings associated with severe illness among hospitalized individuals with COVID-19 in Medan, Indonesia: a cross-sectional study

F1000Research ◽  
2022 ◽  
Vol 10 ◽  
pp. 1246
Author(s):  
Darmadi Darmadi ◽  
Cennikon Pakpahan ◽  
Riska Habriel Ruslie ◽  
Andri Rezano
Keyword(s):  
Cross Sectional Study ◽  
Tnf Alpha ◽  
Severe Illness ◽  
Cytokine Storm ◽  
Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Ifn Gamma ◽  
Neutrophil Lymphocyte Ratio ◽  
D Dimer

Background: Coronavirus disease (COVID-19) remains a global health problem. COVID-19 patients with severe pneumonia have a higher risk for critical illness, mostly complicated by acute respiratory distress syndrome. The inflammatory response is critical, and the cytokine storm increases the severity of COVID-19. Many factors could be associated with a cytokine storm but they are incompletely understood. This study presents characteristics of COVID-19 patients and explore the clinical and inflammatory parameters of severe and critically ill COVID-19 patients in the intensive care unit (ICU). Method: This cross-sectional study was conducted in all severe COVID-19 patients admitted to the ICU. Peripheral blood was taken for laboratory examination within 24 hours of admission. Haematologic parameters, serum electrolyte, renal function, liver function, pancreas enzyme, D-dimer, inflammatory cytokines interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-10, monocyte chemoattractant protein-1 (MCP-1), and C-reactive protein (CRP) were assessed in this study. Comparative analyses were done between sex, existing comorbidities, body mass index (BMI), and COVID-19 vaccination status. Results: A total of 80 subjects were included in the study. The most frequent comorbidities found among the subjects were obesity (36.35%) and diabetes (22.5%). Only 13.75% of subjects were vaccinated. Laboratory results indicated leucocytosis and neutrophilia, with a neutrophil-lymphocyte-ratio (NLR) of 7. The mean inflammatory findings (IL-6, IL-10, TNF-alpha, IFN-gamma, MCP-1), D-dimer, CRP, and lipase increased. Lipase levels were higher in men (p = 0.003) and in comorbidity groups. No significant differences were found among different BMI groups. Lipase, IL-6, and MCP-1 levels were significantly higher (p=0.019, <0.0001, and 0.03, respectively) in the non-vaccinated group. Conclusions: Most patients with severe COVID-19 have comorbidities and increased inflammatory markers.

scholarly journals Role of biomarkers in predicting prognosis of Coronavirus disease 2019 (COVID-19): A retrospective cross-sectional study: Perspective of a tertiary care hospital in India

2021 ◽  
Vol 11 (1) ◽  
pp. 081-090
Author(s):  
Arushi Mohan ◽  
Padmini SN ◽  
Brunda MS ◽  
Abhinaya Shekhar ◽  
Paul Matthew ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Oxygen Requirement ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Significant Difference ◽  
D Dimer

Background: COVID-19 is a novel disease triggered by the SARS-CoV-2 virus, a beta coronavirus similar to MERS-CoV and SARS CoV. Inflammatory markers have a vital role in the pathogenesis of nCOVID 19; understanding the importance of these inflammatory markers in determining disease status is essential given the impact of the disease on healthcare. Thus, being able to triage cases with minimal tests is momentous to capture, which we have investigated as per our study guidelines of the role of inflammatory markers such as D-dimer, CRP (C - reactive protein), Ferritin, LDH (Lactate Dehydrogenase) in patients with COVID 19. In addition, limited data is available comparing the utility of these inflammatory markers to predict the following parameters as the need for ICU, oxygen support requirement, and duration of in-hospital stay, which can help guide the management protocol. Aim: This study aims to determine markers associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). Objectives: 1) To assess the inflammatory markers that are routinely investigated in COVID- 19 patients. 2) To determine the most probable factor to estimate severity in COVID- 19 and thus predict prognosis. Methods: This is a retrospective cross-sectional observational study of patients who tested SARS COV 2 positive by RT PCR. The laboratory inflammatory markers, namely Lactate Dehydrogenase, C reactive protein, D-dimer, Ferritin, were assessed in the selected patients, and their clinical data and demographic details were taken into account. The parameters considered for contributing to the severity included the number of days of stay in the hospital, oxygen requirement, and ICU needs. Analyses relied upon analysis of variance for cross-sectional study design and a P< 0.05 statistical significance criterion. Results: There was a statistically significant difference found between oxygen requirement and D dimer (p<0.001), LDH (p= 0.002), and CRP (p= 0.024). There was a statistically significant difference found between admission to ICU and D Dimer (p= 0.001). Conclusion: A statistically significant association between the increasing D-dimer levels and all the outcome measures considered was found. The D-dimer, LDH, and CRP help predict oxygen requirement, and all the inflammatory markers can predict the number of days of stay in the hospital.

scholarly journals COVID-19: HRCT lung pattern, distribution and severity score with clinico-pathological correlation in a tertiary level institution in rural Maharashtra

2021 ◽  
Vol 8 (12) ◽  
pp. 1821
Author(s):  
Kumar Snehil ◽  
Amol S. Bhoite ◽  
Tamboli Asif ◽  
Radha R. Bawage ◽  
Shreya R. Garg ◽  
...  
Keyword(s):  
Predictive Value ◽  
Severity Score ◽  
Pearson Correlation ◽  
Lower Lobe ◽  
Clinical Severity ◽  
Ground Glass ◽  
Common Finding ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
D Dimer

Background: The severe acute respiratory syndrome corona viruses 2 (SARSCoV-2) are enveloped positive sense RNA virus. Most patients of coronavirus disease 2019 (COVID-19) show fever, cough, dyspnoea and myalgia with weakness.Methods: In this retrospective cross-sectional study 502 patients who were RT-PCR positive for COVID-19 participated in our study after informed consent was taken from all patients, during the period of 3 months between July to September 2020. The study was conducted in Department of Radiodiagnosis at Krishna Institute of Medical Sciences in karad. Each HRCT-Lung scan was evaluated for distribution (central or peripheral); findings (like ground glass opacities, interlobular septal thickening). Every lobe was then allotted CT severity score.Results: The threshold cut-off value for HRCT severity score was found to be 8. The parameters achieved with this cut-off value were: sensitivity – 100%, specificity- 95.15%, positive predictive value- 85.7%, negative predictive value – 100%. On application of pearson correlation coefficient between HRCT severity score and pathological parameters, it was found that strongest correlation was found to be with D-dimer values (0.833), then with ESR (0.484) and least with N/L (neutrophil/lymphocyte) ratio (0.350).Conclusions: On imaging, HTCT thorax showed most common involvement to be peripheral, ground glass opacity and crazy paving being most common findings. The most common finding being left and right lower lobe. The ROC curve showed the CT severity score corresponding to clinical severity to be 8. Among pathological parameters, the strongest correlation with CT severity score was found to be with D-dimer.

scholarly journals ANGKA BANDING NETROFIL/LIMFOSIT DI POPULASI DEWASA MUDA

2018 ◽  
Vol 22 (2) ◽  
pp. 105
Author(s):  
Arie Yanti ◽  
Uleng Bahrun ◽  
Mansyur Arif
Keyword(s):  
Adult Population ◽  
Reference Value ◽  
Severe Infection ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Checkup ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference

Previous studies have shown that neutrophil/lymphocyte ratio in bacteremia is higher than nonbacteremia, therefore it could beused as a marker to distinguish both conditions in patients with sepsis .Another study on oncology patients in ICU showed a correlationbetween the severity of clinical course and the increase of neutrophil/lymphocyte ratio. In physiological condition, neutrophil/lymphocyteratio <5, while in pathological conditions (severe infection or systemic inflammation) neutrophil/lymphocyte ratio increases >6.Neutrophil/lymphocyte ratio is a sensitive, fast, cost effective and applicable laboratory test for routine use, therefore this test result canbe used as the parameter to assess clinical condition of patients. However, a reference value of neutrophil/lymphocyte ratio has neverbeen defined, especially in Makassar City, South Sulawesi Province. The aim of this study was to know the neutrophil/lymphocyte ratioin a healthy young adult population. A cross sectional study was conducted from March to April 2014, involving residents (specialisticcandidates in Medical Faculty, Hasanuddin University, who underwwent medical checkup and voluntarily joined this study. Samplesconsisted of 198 persons who fulfilled the inclusion criteria with an age range between 24-40 years old, comprising 84 males (42.42%)and 114 females (57.58%). The neutrophil/lymphocyte ratio for all samples was 1.95 (1.15-4.74). Mann Whitney test showed thatthere was no significant difference of neutrophil/lymphocyte ratio between males and females, 1.88 (1.25-4.74) vs 1.95 (1.15-4.12),p=0.65 and neither between the age group 21-30 years old and 31-40 years old, 1.95 (1.21-4.74) vs 1.94 (1.15-4.09), p=0.82.

scholarly journals Correlation of the severity of HRCT findings with the other hematologic parameters & viral load in patients with confirmed COVID – 19 Infection

2021 ◽  
Vol 12 (9) ◽  
pp. 4-10
Author(s):  
Anjali Goyal ◽  
Misha Antani ◽  
Suhani Agarwal ◽  
Chandni Gadara ◽  
Milap Shah ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Viral Clearance ◽  
Care Hospital ◽  
Laboratory Parameters ◽  
Duration Of Hospital Stay ◽  
Severity Scores ◽  
Wbc Count ◽  
D Dimer

Background: The latter half of 2019 saw the spread of a highly contagious and fatal respiratory tract disease originating in the Hubei province of Wuhan in China which was labelled as COVID 19. Although a multi organ disease, it is seen to spread through the respiratory tract with lung being the primary target. Aims and Objective: The study was conducted to correlate the severity of lung involvement as assessed by the HRCT severity, with the Viral Severity index, laboratory parameters, duration of hospital stay, viral clearance and resolution of lung symptoms. Materials and Methods: An observational retrospective study was carried out from the laboratory records of consecutive 208 patients admitted to the tertiary care hospital between March 2020 to May 2020. Results: Out of a total of 208 patients, 200(96%) recovered and 8(4%) expired. The expired patients showed a higher average age (50.79+/- 17.42; 62.25+/-12.37) years in the recovered & expired patients respectively (p=0.06). A longer duration of hospital stay was seen in the expired patients (15.05+/-9.55&18.62+/-10.22) days in the recovered & expired patients respectively. A low average (Hemoglobin) Hb values (12.17+/-2.01&10.9+/-2.31) g/dl in the recovered and expired patients respectively along with a higher total WBC count was seen in the expired patients (8.62+/-3.81& 16.86+/-12.79) k/U in the recovered and expired patients with a highly significant p value of < 0.001). Higher CT severity scores were seen in the expired patients (10.74+/-5.57&17.12+/-6.55) in the recovered and expired patients respectively (p=0.0018). None of the expired patients had a normal D Dimer level. HRCT values and the Rising D Dimer levels tend to show a positive correlation with the disease outcome and progression. The Higher Viral severity and HRCT score was associated with a longer duration of hospital stay reflecting a higher duration of viral clearance. Conclusion: The Chest CT scores along with the laboratory parameters like the total WBC count and the D Dimer levels can together act as important parameters to monitor the Covid 19 disease course.

scholarly journals Comparison of D-Dimer Level on Mild, Moderate and Severe COVID-19 at Immanuel Hospital Bandung City October 1 st - December 31 st, 2020

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4268-4268
Author(s):  
Hary Gustian ◽  
Regina Anjani Budi Pratiwi ◽  
Rini Riantie
Keyword(s):  
Conflicts Of Interest ◽  
Sandwich Elisa ◽  
Patient Classification ◽  
Cross Sectional ◽  
A Value ◽  
Significant Difference ◽  
The Mean ◽  
Cross Sectional Design ◽  
Severity Of The Disease ◽  
D Dimer

Abstract Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In COVID-19 there is a process of thrombosis and coagulopathy, which are systemic inflammation and endothelial disorders resulting in hypercoagulability. D-dimer is a laboratory test that can determine coagulation activation (hypercoagulability) and fibrinolysis. D-dimer can be used as a guide of anticoagulant and thrombolytic therapy and prognostic parameter in COVID-19 patients, where its value runs parallel to the severity of the disease and is associated with increased mortality. Materials and methods: The whole sampling was taken from 59 medical records of inpatients confirmed with COVID-19 through the RT-PCR examination at Immanuel Hospital, Bandung City for the period of October 1 st - December 31 st, 2020. The value of d-dimer was taken from whole blood, tested with sandwich ELISA method with cut-off value (normal value) &lt; 0.5μg/ml. COVID-19 patient classification was based on the COVID-19 guideline from Indonesian Ministry of Health. The research method was observational analytical with cross-sectional design. Statistical test used was Kruskal-Wallis test with Mann-Whitney advanced test (α = 0.05). Results: The mean d-dimer value in patients with mild, moderate, and severe COVID-19 was 0.3034 µg/mL; 0.5138 µg/mL; and 1.1751 µg/mL. The results of Kruskal-Wallis test showed a very significant difference in mean d-dimer values in mild, moderate, and severe COVID-19 patients. Mann-Whitney test showed that there was a very significant difference in the mean d-dimer value between mild and severe COVID-19 patients, also between moderate and severe COVID-19 patients with a value of p = 0.000 (p &lt;0.01). But there was no difference in the mean d-dimer value between mild and moderate COVID-19 patients, p = 0.454 (p&gt; 0.05). Conclusion: There is a very significant difference in d-dimer values between mild, moderate and severe COVID-19 patients. The d-dimer value increases with the severity of COVID-19. Keywords: COVID-19, mild COVID-19, moderate COVID-19, severe COVID-19, d-dimer Disclosures No relevant conflicts of interest to declare.

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