A clinical audit done on association between d-dimer and other markers of prognosis in covid-19 patients

Abstract

 COVID-19 disease is known to cause coagulopathic complications by inducing inflammatory mechanisms. D-dimer is an effective marker of active fibrinolysis that has been considered relevant in the assessment of such complications and in the treatment course of the disease. Focus of this cross-sectional study conducted among COVID 19 in-patients was to assess

whether any significant statistical association exists between their D-dimer values and eight other markers of prognosis.

OBJECTIVE: To assess the association between D-dimer and other markers of prognosis in COVID-19 patients admitted and treated in a tertiary Care Centre in Central Kerala.

METHODS: A cross-sectional study was conducted among 129 COVID-19 patients admitted in the COVID Care Unit of the study Centre, selected through Simple Random Sampling. A predesigned, pretested, validated checklist was used to collect the required data from medical records of patients during the period of October-December 2021.Association between variables were estimated with Pearson Chi-square test.

RESULTS: Out of the markers, Age(p=0.000), Diabetic status (p=0.042), Hypertensive status (p=0.007), Need for Critical Care(p=0.001) and Treatment Outcome(p=0.039) showed significant association with D-dimer values while Sex (p=0.331), Duration of Hospital Stay(p=0.768) and Vaccination Status (0.755) did not.

CONCLUSION; As the results of the study suggest, significant association exist in COVID-19 patients between their elevated D-dimer values and pre-existing co-morbidities like Age, Diabetes and Hypertension. Such patients were also more in need of Critical Care and had worse Treatment Outcome. In such patients, assessment of laboratory D-dimer values can be an early indicator of thromboembolic complications. Thus, D-dimer can be a valuable tool in prompting suspicion and early detection of coagulopathy in COVID-19 which shall reduce mortality to an extent by ensuring timely intervention