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VOLUME 27 , ISSUE 2 ( February, 2023 ) > List of Articles

BRIEF RESEARCH COMMUNICATION

Study to Determine a Prognostic Cutoff Values of the Coagulation Analyte D-dimer for ICU Admission among COVID-19 Patients

Mary Chandrika Anton, B Shanthi, E Vasudevan

Keywords : Coronavirus disease-2019, D-dimer, Intensive care unit, Prognosis, Prognostic cutoff

Citation Information : Anton MC, Shanthi B, Vasudevan E. Study to Determine a Prognostic Cutoff Values of the Coagulation Analyte D-dimer for ICU Admission among COVID-19 Patients. Indian J Crit Care Med 2023; 27 (2):135-138.

DOI: 10.5005/jp-journals-10071-24395

License: CC BY-NC 4.0

Published Online: 31-01-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Introduction: The measured D-dimer levels in coronavirus disease-2019 (COVID-19) patients have no specific cutoff to find the progression of coagulopathy and severity. Aim: This study aimed to determine prognostic cutoff values of D-dimer for intensive care unit (ICU) admission among COVID-19 patients. Materials and methods: This cross-sectional study was conducted in Sree Balaji Medical College and Hospital, Chennai, during a period of 6 months. This study included 460 COVID-19-positive individuals. Results: The mean age was 52.2 ± 12.53 years. Patients with mild illness have D-dimer value 461.8 ± 221, whereas moderate and severe COVID illness patients have D-dimer values of 1915.2 ± 699.9 and 7937.6 ± 2045.2, respectively. D-dimer cutoff value of 1036.9 is shown to be a prognostic cutoff value for COVID-19 patients admitted in the ICU with 99% sensitivity and 17% specificity. The area under curve (AUC) was considered excellent (AUC = 0.827, 95% Cl: 0.78–0.86, p-value < 0.0001) indicative of high sensitivity. Conclusion: The D-dimer value of 1036.9 ng/mL was found to be the optimum cutoff for the patients to predict the severity of the COVID-19-positive patients admitted in the ICU.


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  1. Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan China: The mystery and the miracle. J Med Virol 2020. DOI: 10.1002/jmv.25678.
  2. Pal M, Berhanu G, Desalegn C, Kandi V. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): An update. Cureus 2020;12(3):e7423. DOI: 10.7759/cureus.7423.
  3. Wang J, Du G. COVID-19 may transmit through aerosol. Ir J Med Sci 2020;189(4):1143–1144. DOI: 10.1007/s11845-020-02218-2.
  4. Baj J, Karakuła-Juchnowicz H, Teresiński G, Buszewicz G, Ciesielka M, Sitarz R, et al. COVID-19: Specific and non-specific clinical manifestations and symptoms: The current state of knowledge. J Clin Med 2020;9(6):1753. DOI: 10.3390/jcm9061753.
  5. Sathish T, Chandrika Anton M. Newly diagnosed diabetes in patients with mild to moderate COVID-19. Diabetes Metab Syndr 2021;15(2):569–571. DOI: 10.1016/j.dsx.2021.02.034.
  6. Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 – A systematic review. Life Sci 2020;254:117788. DOI: 10.1016/j.lfs.2020.117788.
  7. Chapin JC, Hajjar KA. Fibrinolysis and the control of blood coagulation. Blood Rev 2015;29(1):17–24. DOI: 10.1016/j.blre.2014.09.003.
  8. Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, et al. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: A case control study. J Intensive Care 2020;8:49. DOI: 10.1186/s40560-020-00466-z.
  9. Egyptian Ministry of Health (MOH) Guidelines for diagnosis and treatment of COVID-19, Version 1.1, March 2020.
  10. Querol-Ribelles JM, Tenias JM, Grau E, Querol-Borras JM, Climent JL, Gomez E, et al. Plasma D-dimer levels correlate with outcomes in patients with community-acquired pneumonia. Chest 2004;126(4):1087–1092. DOI: 10.1378/chest.126.4.1087.
  11. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical characteristics of Coronavirus disease 2019 in China. N Engl J Med 2020;382:1708–1720. DOI: 10.1056/NEJMoa2002032.
  12. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost 2020;18(6):1324–1329. DOI: 10.1111/jth.14859.
  13. Shah S, Shah K, Patel SB, Patel FS, Osman M, Velagapudi P, et al. Elevated D-dimer levels are associated with increased risk of mortality in coronavirus disease 2019: A systematic review and meta-analysis. Cardiol Rev 2020;28(6):295–302. DOI: 10.1097/CRD.0000000000000330.
  14. Rostami M, Mansouritorghabeh H. D-dimer level in COVID-19 infection: A systematic review. Expert Rev Hematol 2020;13(11):1265–1275. DOI: 10.1080/17474086.2020.1831383.
  15. Li Y, Deng Y, Ye L, Sun H, Du S, Huang H,et al. Clinical significance of plasma D-dimer in COVID-19 mortality. Front Med 2021;8:638097. DOI: 10.3389/fmed.2021.638097.
  16. Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, et al. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: A case control study. J Intensive Care 2020;8:49. DOI: 10.1186/s40560-020-00466-z.
  17. Yu H-H, Qin C,Chen M,Wang W, Tian D-S. D-dimer level is associated with the severity of COVID-19. Thromb Res 2020;195:219–225. DOI: 10.1016/j.thromres.2020.07.047.
  18. Yu B, Li X, Chen J, Ouyang M, Zhang H, Zhao X, et al. Evaluation of variation in D-dimer levels among COVID-19 and bacterial pneumonia: A retrospective analysis. J Thromb Thrombolysis 2020;50(3):548–557. DOI: 10.1007/s11239-020-02171-y.
  19. Poudel A, Poudel Y, Adhikari A, Aryal BB, Dangol D, Bajracharya T, et al. D-dimer as a biomarker for assessment of COVID-19 prognosis: D-dimer levels on admission and its role in predicting disease outcome in hospitalized patients with COVID-19. PLoS One 2021;16(8):e0256744. DOI: 10.1371/journal.pone.0256744.
  20. Kapoor M, Panda PK, Saini LK, Bahurupi Y. Disseminated intravascular coagulation score and sepsis-induced coagulopathy score in prediction of COVID-19 severity: A retrospective analysis. Indian J Crit Care Med 2021;25(12):1357–1363. DOI: 10.5005/jp-journals-10071-24056.
  21. Zirpe KG, Bamne SN. Compass in COVID-19 illness: Disseminated intravascular coagulation/sepsis-induced coagulopathy scoring in predicting severity. Indian J Crit Care Med 2021;25(12):1333–1334. DOI: 10.5005/jp-journals-10071-24061.
  22. Kaneria MV, Nadaf S, Desai U. Clots in COVID: A case series. Indian J Crit Care Med 2021;25(7):817–821. DOI: 10.5005/jp-journals-10071-23897.
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