Role of 'Serial D-Dimer Level' in predicting Severity and outcome in COVID-19 pneumonia: A Prospective multicentric Observational Study of 1000 cases in Tertiary Care Setting in India

Patil, Shital

doi:10.14744/ejma.2022.36854

Cited by 10 publications

(31 citation statements)

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“…Covid-19 patients [36,37], however due to the study design we were unable to explore this promising work-up strategy. Moreover, we were able to retrieve only laboratory test and parameters that were analysed during routine hospital management<ins cite="mailto:User" datetime="2022-12-18T21 : 04">.…”

Section: U N C O R R E C T E D a U T H O R P R O O Fmentioning

confidence: 99%

Predictive value of inflammatory and coagulation biomarkers for venous thromboembolism in COVID-19 patients

Hojker

Tršan

et al. 2023

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BACKGROUND: The predictive value of coagulation markers for venous thromboembolism (VTE) in Covid-19 patients has been investigated with conflicting results. OBJECTIVE: Our aim was to investigate the correlation between biomarkers and VTE and the predictive value of D-dimer for VTE in hospitalized Covid-19 patients. METHODS: Complete blood count, inflammatory and coagulation biomarkers at admission were collected. VTE was defined as diagnosed pulmonary embolism or deep vein thrombosis. Events were defined as in-hospital death or ICU admission. Predictors of VTE were identified with Pearson prediction models. A ROC curve was constructed to assess the predictive value of D-dimer. RESULTS: 1651 participants were included, 111 VTE were identified. Events incidence was higher in the VTE group (49.5% vs 28.2%, p < 0.001). Neutrophil-lymphocyte ratio (NLR, 0.001; 95% CI 0.000–0.002; p 0.019) and D-dimer (0.00005; 95% CI 0.00002–0.00008; p < 0.001), Geneva score (0.026; 95% CI 0.012–0.040; p < 0.001) and Wells score (0.047; 95% CI 0.033–0.061; p < 0.001) were associated with VTE. D-dimer had a goor predictive value for VTE (ROC area 0.85, 95% CI 0.816–0.893), with an optimal cut-off value of 2677μg/L (Youden index of 0,602). CONCLUSIONS: Among coagulation biomarkers D-dimer had the best predictive value for VTE, but higher cut-off values should be used in Covid-19.

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Section: U N C O R R E C T E D a U T H O R P R O O Fmentioning

confidence: 99%

Predictive value of inflammatory and coagulation biomarkers for venous thromboembolism in COVID-19 patients

Hojker

Tršan

et al. 2023

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“…Thromboembolism and hypercoagulability may be implicated in pathogenesis of pulmonary fibrosis. Epidemiologic observations have supported this possibility [17,25,26]. A large cohort study showed that the incidence rates of ILD were higher in patients with a history of venous thromboembolism or pulmonary embolism than in control patients [48].…”

Section: Thromboembolism and Post Covid Lung Fibrosismentioning

confidence: 98%

“…Given that survivors of COVID-19 who develop persistent pulmonary disease will require long term specialty care, all clinicians have a vested interest in understanding and mitigating the various risk factors associated with post-COVID-19 pulmonary fibrosis (PCPF). Potential contributing etiologies for PCPF include viral pneumonia and pneumonitis [12][13][14][15][16][17][18]; ARDS from COVID-19 pneumonia and COVID-19 related sepsis [16][17][18][19][20][21]; trauma due to prolonged mechanical ventilation (MV) [21][22][23][24]; thromboembolism [17,19,25,26]; hyperoxia [18,19,27,28]; and dysregulations in the immune response [29][30][31][32][33][34]. Pathophysiology of post covid lung fibrosis is well established and follows same pathway of ARDS due to any cause such as injury, inflammation, exaggerated inflammation, repair and fibrosis.…”

Section: Post Covid Lung Predictors and Pathophysiologymentioning

confidence: 99%

“…The immune induced mechanism of PF is important to address. Immune-related damage contributes to COVID related ARDS [12][13][14][15][16][17]. Also, transforming growth factor beta (TGF-β) is a cytokine thought to be a crucial mediator of initiation and progression of fibrosis and remodeling [54].…”

Section: Pro-inflammatory State and Post Covid Lung Fibrosismentioning

confidence: 99%

“…Authors have documented that serial inflammatory markers measurement of during hospitalization irrespective of entry point level has very well correlation with outcome and requirement of interventions in intensive care setting, which will indirectly help in predicting future risk of development of post covid lung fibrosis in majority of cases required aggressive interventions like high flow nasal canula, BIPAP/NIV, ECMO, Invasive mechanical ventilation irrespective of inflammatory markers level reaching to cytokine storm. Serial measurements also predict chances of lung fibrosis in these patients as cytokine induced lung damage resulted in lung necrosis and resultant lung fibrosis [11][12][13][14][15][16][17]. Few studies have documented inflammatory markers analysis after few months of follow-up is not very good predictor of post covid lung fibrosis especially after one year duration [58].…”

Section: Does Inflammatory Makers Analysis During and During Follow U...mentioning

confidence: 99%

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Nintedanib as an Antifibrotic in Post Covid Lung Fibrosis: Are we Really Overestimating?

Patil¹,

Tandel²,

Bhangdia³

et al. 2023

SAR J Med

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Antifibrotics were exuberantly used to treat post covid lung complications. Lung is the primary target organ in COVID-19 disease with diverse clinical and radiological presentations and outcome. It has caused minimal to moderate lung disease in some patients and in some cases caused deadly acute respiratory distress syndrome (ARDS). COVID-19 disease caused lung damage by direct virus induced alveolar damage, cytokine induced alveolar and vascular damage and microvascular thrombosis resulting into acute hypoxic respiratory failure. COVID-19 pneumonia evolved over period of three weeks in cases with ARDS as natural course of illness. Usually, ARDS resolves by fibrosis or resolution as final outcome. Similarly, in COVID-19 recovered cases of advanced disease or those suffering from ARDS are having post covid lung disease. Lung fibrosis is final radiological outcome of COVID-19 pneumonia documented in proportionately majority of cases. Post COVID lung fibrosis is considered as worrisome radiological complication observed during early phase of pandemic. Antifibrotics such as Nintedanib and Pirfenidone were used to treat post covid lung complications such as fibrosis. Both drugs were shown good antifibrotic property in clinical trials for fibrotic lung disease and observed positive outcome in restoring lung parenchyma. Time trends of final radiological outcome has evolved over months with or without treatment with antifibrotics and steroids. Importantly, Post covid lung fibrosis resolved more than fifty percent cases in six months and nearly in all cases after one year. Thus, antifibrotics were used irrationally in fibrosing lung condition of reversible type. Actually, we have overestimated post covid lung fibrosis and overtreated with antifibrotics.

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The Factors Associated with Variation in Length of Hospital Stay in Covid19 Patients

2023

The Egyptian Journal of Hospital Medicine

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Background:The COVID-19 pandemic has significantly burdened healthcare and economic infrastructures. Identifying indicators linked to hospitalization requirements and duration of stay (LOS) could be crucial for efficiently allocating resources and prioritizing patient care. Objectives:The purpose of this study was to investigate, retrospectively, the variables influencing the length of hospital stay (LoS) for patients with COVID-19. Patients and Methods: This study included 300 patients with Covid 19 who were admitted to the 23 July Chest Hospital, El Marg Qaluobia Government, during the period from october 2020 to September 2022. Patients were divided according to length of hospital stay into 2 groups; Not prolonged group; included 170 patients (56.7%) with LoS < 11 days, and Prolonged group; included 130 patients (43.3%) with LOS > 11 days. Patients were subjected to complete history taking and physical examination. Complete blood count (CBC), C-reactive protein, D-dimer, liver function tests, kidney function tests, radiological examinations and Naso-pharyngeal swab were done. Results: prolonged group were statistically older (61±11 years) than not prolonged group (48±13 years), p <0.001. Also, comorbidities and smoking were common in prolonged than the other group. Anemia, leucopenia, lymphopenia, thrombocytopenia were more common in prolonged group than the other group. Also, all cases in prolonged group showed elevated d-dimer, CRP, higher frequencies of bilateral pulmonary infiltration and consolidation compared with not prolonged group. Conclusion: Old age, comorbidities and smoking are associated with prolonged hospital stay. In addition, O2 saturation < 86%, high levels of blood glucose, D dimer, CRP are significant independent predictors of prolonged hospital stay.

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Role of 'Serial D-Dimer Level' in predicting Severity and outcome in COVID-19 pneumonia: A Prospective multicentric Observational Study of 1000 cases in Tertiary Care Setting in India

Cited by 10 publications

References 0 publications

Predictive value of inflammatory and coagulation biomarkers for venous thromboembolism in COVID-19 patients

Predictive value of inflammatory and coagulation biomarkers for venous thromboembolism in COVID-19 patients

Nintedanib as an Antifibrotic in Post Covid Lung Fibrosis: Are we Really Overestimating?

The Factors Associated with Variation in Length of Hospital Stay in Covid19 Patients

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