D-dimer as a predictive and prognostic marker among COVID-19 patients

Saudi Med J. 2022 Jul;43(7):723-729. doi: 10.15537/smj.2022.43.7.20220213.

Abstract

Objectives: To examine D-dimer, coagulation profile, and platelet count among patients hospitalized with coronavirus disease-19 (COVID-19) and compare them to findings from non-COVID-19 subjects.

Methods: The participants in this retrospective hospital-based observational study design included 112 confirmed diagnosed with COVID-19 who were admitted to King Khaled Hospital, Najran, Saudi Arabia, and another 112 non-COVID-19 subjects as a comparative group. Laboratory investigations, demographic and clinical records were obtained from participants' electronic indexed medical records. Coronavirus disease-19 diagnosis was confirmed according to positive real time polymerase chain reaction assay carried out at the hospital's central laboratory, where samples were extracted from a nasopharyngeal swab. Pneumonia related to COVID-19 is classified as critical, severe, moderate, mild, and asymptomatic whereas thrombocytopenia was marked when the platelet count was <150.00×109/L. Suitable statistical analysis was applied to determine possible differences between the findings from the 2 groups.

Results: The D-dimer and activated partial thromboplastin clotting time mean values were significantly elevated (p<0.001). The international normalized ratio and platelet count mean values confirmed a significant decrease (p<0.001). Thrombocytopenia was found 9 times in COVID-19 higher than in the non-COVID-19. D-dimer and prothrombin time mean values increased significantly among the COVID-19 patients with all patterns of symptoms on admission (p<0.001).

Conclusion: D-dimer mean values increased significantly in deceased COVID-19 and in hospitalized intensive care unit (ICU) wards patients (p<0.001), indicating a potential predictive and prognostic severity marker, particularly among COVID-19 patients in the ICU.

Keywords: D-dimer; Najran; platelets count; thrombocytopenia.

Publication types

  • Observational Study

MeSH terms

  • COVID-19* / blood
  • COVID-19* / diagnosis
  • Fibrin Fibrinogen Degradation Products* / metabolism
  • Humans
  • Prognosis
  • Retrospective Studies
  • Thrombocytopenia* / blood
  • Thrombocytopenia* / virology

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D