The Effectiveness of Platelet and D-Dimer Levels in Predicting Prognosis in Intensive Care Patients Diagnosed With COVID-19

Abstract

Background: The pathophysiology of coagulopathy in patients with Corona virus disease 2019 (COVID-19) and its clinical manifestations remain unclear. However, several studies have reported abnormal coagulation parameters, notably in patients with COVID-19 associated pneumonia and acute respiratory distress syn-drome. Although the underlying mechanism of COVID-19 coagulopathy remains unknown, it has been sug-gested to be a form of disseminated intravascular coagulation. We aimed to determine the predictive value of platelet count and D-dimer levels in predicting prognosis in intensive care patients with a diagnosis of COVID-19.Materials and Methods: Demographic, clinical, laboratory data and radiological findings were obtained from the hospital electronic patient record using a standard data collection form. Platelet counts and D-dimer data were noted. Intensive care stay, mechanical ventilator duration and hospital stay of the patients were ana-lyzed retrospectively. Clinical data covers also comorbid conditions.Results: The study included 102 intensive care patients with COVID-19 diagnosis. All the patients had Poly-merase Chain Reaction (PCR) confirmation and abnormalities on chest computed tomography (CT) consistent with COVID-19. Bilateral pneumonia proven by chest CT was reported in 91.2% of the patient. The platelet count of patients who died was median 247x109 /L (min-max 192 - 354), D dimer levels was median 7.03 (min-max 3.36-17.7) mg/L. Patients who living were platelet counts median 310 x109/L (min-max 234 – 350), D-dimer levels median 1.59 (min-max 0.82 -2). There was no statistically significant difference when the platelet count of the survived and deceased patients were compared (p=0.193). But the patients who died was D-dimer levels statistically higher (p=0.001).Conclusions: High or non-decreasing D-dimer levels may indicate poor prognosis in patients with COVID-19 pneumonia whereas platelet counts don’t have a predictive value.

Investigation of the relationship between coagulation parameters and mortality in COVID-19 infection

“…In our study, sensitivity and specificity of aPTT were 59.7% and 59.2%, respectively, whereas compared to the investigation conducted by Citu et al, 37 the specificity values were significantly lower in our study and differed in this respect. In another study, Altay et al 38 investigated the relationship between platelet and d-dimer levels and COVID-19 outcome and demonstrated that platelet levels did not constitute a significant difference according to survival groups ( P = .193). On the contrary, in our study, platelet levels were seen to be lower in the exitus group and constituted a significant difference ( P < .001).…”