Prognostic Significance of D-dimer Levels in Predicting Severity and Mortality in COVID-19 Patients: A Comprehensive Analysis | Chapter 5 | Disease and Health: Research Developments Vol. 3

Aim and Objective: The study aims to evaluate the relationship between D-dimer levels and COVID-19 severity and mortality.

Materials and Methods: The study retrospectively analysed the patients (Age about ≥16 years) having confirmed the diagnosis of COVID-19 along with or without comorbid conditions. Pathological and radiological characteristics of 2087 consecutive cases of COVID-19 in Parul Sevashram Hospital, Vadodara, Gujarat, from March 2021 to July 2022. Correlations of D-dimer level of COVID-19 patients upon admission with disease severity and in-hospital mortality were analyzed accordingly. Graphically MS-Excel with median values were used.

Results: 2087 patients having positive RT-PCR and confirmed diagnosis of COVID-19 were included upon hospital admission. Whereas 65.78% (n= 1373) were male and 34.21% (n= 714) were female. The mean age was 52± 4 years. 319 patients died during above said period and overall, the in-hospital mortality rate was 15.28%. Initially, patients were kept on NIV and then shifted to a ventilator based on Spo2 level and continued monitoring. Additionally, 6.08 % (n=127) of patients were on BIPEP and OBPEP and all died with a 100% death ratio. None of the intubated patients (5.60 %, n= 117) were survived. The median elevated D-dimer level was 600.5 ng/ml throughout the study.  81.5 % (n= 1701) patients were found to have elevated D-Dimer levels, and 19.5 % (n= 386) patients were within the normal range. The median D-dimer level in non-survivors (15.29%) was significantly higher than in survivors (84.71%, n = 1768, RR 24.69%). Furthermore, the disease activity was higher in the overhead D-dimer level group demonstrated to have anticipating value in differentiating disease severity along with high ESR level, hs-CRP and the fibrinogen level was also upraised indicating the seriousness of the disease.

Conclusion: It was concluded that D-dimer level was routinely uplifted in patients with COVID-19 disease and significantly matched up with the severity of the disease. D-dimer is a significant definitive prognostic first-line marker with twice as high on admission than normal range in COVID-19 and indicates the seriousness of disease.

 

Author (s) Details

 

Niraj Chawda
Department of Medicine, SBKS Medical Institute and Research Centre, Piperiya, Gujarat, India.

 

Suresh Jain
Department of Medicine, Bombay Hospital and Medical Research Centre, Mumbai, India.

 

Bhagirath Solanki
Department of Medicine, B.J Medical College, Ahmedabad, Gujarat, India.

Chetan Sonkar
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

Simran Arora
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

Sukruti Shah
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

Vtrag Tejani
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

Jyot Kaur Chawla
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

Mukesh Chaudhari
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

Ravi Chaudhari
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

Amal Kumar Bhattacharya
Department of Medicine, Parul Institute of Medical Sciences & Research (PIMSR), Parul Sevashram Hospital, Parul University, Limda, Waghodia- 391760, Vadodara, Gujarat, India.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v3/3507