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Coagulation profile and correlation between D-dimer, inflammatory markers, and COVID-19 severity in an Indonesian
Lugyanti Sukrisman1, Robert Sinto2
1Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
Insights
Elevated D-dimer and C-reactive protein (CRP) levels correlate with COVID-19 severity. A combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L can help identify severe cases of coronavirus disease 2019.
Area of Science:
- Medical Research
- Infectious Diseases
- Hematology
Background:
- Coagulopathy and inflammation are linked to severe coronavirus disease 2019 (COVID-19).
- Understanding biomarkers for COVID-19 severity is crucial for patient management.
Purpose of the Study:
- To assess D-dimer concentration in COVID-19 patients.
- To evaluate the correlation between D-dimer, inflammatory markers (CRP, ferritin), and COVID-19 severity.
Main Methods:
- Retrospective cross-sectional study of 194 COVID-19 cases.
- Graded infection severity using World Health Organization (WHO) guidelines.
- Measured D-dimer, C-reactive protein (CRP), and ferritin on admission.
Main Results:
- Median D-dimer: 2240 µg/L, CRP: 73.2 mg/L, Ferritin: 1173.8 µg/mL.
- Significant correlation found between D-dimer and CRP (r=0.327).
- Combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L showed an AUC of 0.722 for predicting COVID-19 severity.
Conclusions:
- The combined use of CRP and D-dimer offers moderate accuracy in identifying severe COVID-19.
- This biomarker combination can aid in assessing disease severity.
Background:
Coagulopathy and inflammation are associated with coronavirus disease 2019 (COVID-19) severity. This study assessed D-dimer concentration and its correlation with inflammatory markers and COVID-19 severity.
Methods:
This was a retrospective cross-sectional study involving 194 COVID-19 cases, with the severity of infection graded in accordance with the World Health Organization (WHO) guidelines. We measured D-dimer, C-reactive protein (CRP), and ferritin on admission and determined the cutoff values for D-dimer and CRP and evaluated the correlation between D-dimer and CRP and ferritin.
Results:
Median D-dimer, CRP, and ferritin concentrations were 2240 µg/L, 73.2 mg/L, and 1173.8 µg/mL, respectively. The highest median D-dimer value was seen in mild and moderate acute respiratory distress syndrome (ARDS). The highest ferritin concentration was seen in severe ARDS. There was a significant correlation between D-dimer value and CRP (r = 0.327), but no significant correlation between D-dimer and ferritin (r = 0.101). The area under the receiver operating characteristic curve (AUC) for the combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L as a marker of COVID-19 severity was 0.722 (95% confidence interval (CI): 0.615-0.781).
Conclusion:
The combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L can be used as marker of COVID-19 severity, with moderate accuracy.
