Introduction: COVID-19 is an infectious disease that mainly
affects the respiratory system, and its etiologic agent is the severe acute
respiratory syndrome virus. The number of medical requests for D-dimer
increased during the COVID-19 pandemic.
D-dimer is a fibrin degradation product and is an indirect marker of
fibrinolysis. If an individual infected with SARS-COV 2 evolves with
aggravation, a result equal to or greater than four times the reference value
of this marker at the time of admission is considered a predictor of mortality.
The most important exam since the beginning of the pandemic, is due to the
thrombotic manifestations resulting from the infection.
Objective: This study aims to evaluate the variation in the
number of medical requests for D-dimer dosage at a given University Hospital
and its profile in the first wave of the COVID-19 pandemic.
Methodology: This is a cross-sectional observational study,
where the results of patients with a COVID-19 profile, identified in the
Emergency Laboratory of a University Hospital, were quantified and medical
causes for D-dimer dosages in the period from 03/01/2020 to 07/03/2020. Data
were collected through qualitative research in the medical records of
hospitalized patients with D-dimer requests, using the computerized system of
the Clinical Pathology Service. Kruskal-Wallis test and Dunn's multiple
comparison test were used for the statistical test.
Results: In the first half of 2020, 1017 requests were
observed. Comparing the 1st quarter with the 2nd quarter of the same year,
there was an abrupt increase of 1274%, no total occurrences from one quarter to
the other, since no 1st quarter, only 69 requests were detected with a median
2231 ng / mL ( interquartile range 175-15605), no longer 2nd quarter this
number jumped to a total of 948 requests with a median 2020 ng / mL
(interquartile range 99-97026).
Conclusion: Although D-dimer does not have high specificity
as a diagnostic tool, it has been very useful as a severity predictor for COVID
19. Despite the enormous impact generated by the substantial increase in demand
for D-dimer demand in this University Hospital, has provoked a solution of
continuity in the provision of services, further studies in risk and disaster
management would be opportune, in order to improve the resolving flow for
situations that, unfortunately, may occur.
Author(s) Details:
Paulo Sérgio de Abreu Junior,
Fluminense Federal University, Brazil.
Hye Chung Kang,
Fluminense
Federal University, Brazil.
Please see the link here: https://stm.bookpi.org/RUDHR-V5/article/view/14028
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