Therapeutics and Clinical Risk Management (Mar 2022)
The Role of D-Dimers in the Initial Evaluation of COVID-19
Abstract
Liliana Baroiu,1,* Ana Cristina Lese,2 Ioana Anca Stefanopol,3,* Alina Iancu,3,4,* Caterina Dumitru,4,5,* Alexandru Bogdan Ciubara,3,* Florin Ciprian Bujoreanu,6 Nicusor Baroiu,7,* Anamaria Ciubara,1,* Alexandru Nechifor,1,4,* Lucretia Anghel,1,* Alin Laurentiu Tatu1,4,6 1Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, Romania; 2“George Enescu” National University of Arts, Faculty of Visual Arts and Design, Iasi, Romania; 3Departament of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, Romania; 4Multidisciplinary Integrated Center of Dermatological Interface Research Center (MICDIR), “Dunărea de Jos” University of Galați, Galati, Romania; 5Pharmaceutical Sciences Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galati, Romania; 6Dermatology Department, “Sf. Parascheva” Infectious Diseases Clinical Hospital, Galati, Romania; 7Manufacturing Engineering Department, Faculty of Engineering, “Dunărea de Jos” University of Galati, Galati, Romania*These authors contributed equally to this workCorrespondence: Ana Cristina Lese, “George Enescu” National University of Arts, Faculty of Visual Arts and Design, No. 29, str. Cuza Voda, Iasi, 700040, Romania, Tel +40232212549, Fax +40232212551, Email [email protected] Florin Ciprian Bujoreanu, “Sf. Parascheva” Infectious Diseases Clinical Hospital, No. 343, str., Traian, Galati, 800179, Romania, Tel +40236334477, Fax +40236467752, Email [email protected]: The COVID-19 pandemic was noted for the high degree of contagion and the large number of cases, as well as for the various clinical forms, from asymptomatic towards rapid evolution to death. The hospitals limited care capacity imposed the need to identify some markers of unfavorable evolution. The purpose of our study is to identify the parameters correlated with COVID-19 unfavorable evolution and to draw the profile of the patient at risk of unfavorable evolution. This set of parameters will help the doctor in deciding whether to hospitalize a patient and in choosing the treatment.Patients and Methods: We performed a prospective, observational, actively controlled study on 849 patients with COVID-19, hospitalized in the Second Clinic of “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital Galati, Romania, between 1.03.2020– 30.11.2020.Results: The parameters statistically significant modified at the admission of the patients with COVID-19 unfavorable evolution were age, oxygen saturation, D-dimers, creatine kinase (CK), troponin, erythrocytes sedimentation rate (ESR), leukocytes, lymphocytes, neutrophils, platelets, hemoglobin (Hb), aspartate transaminase (AST), total and direct bilirubin (TBIL, DBIL), urea, creatinine, serum glucose. Strong correlations were observed between the unfavorable evolution and the admission values of D-dimers, AST, TBIL and between D-dimers and AST, which suggests that D-dimers levels can be considered predictive for the alteration of liver function and for the negative prognosis of the patient.Conclusion: Coagulation disorders and acute respiratory failure are the prevailing causes of death from COVID-19. Together with other parameters that constitute the risk profile for severe COVID-19 evolution, the D-dimers dosing at admission proved to be extremely useful in the management of COVID-19.Keywords: COVID-19, D-dimer, aspartate transaminase, total bilirubin, unfavorable evolution marker
