Acta Medical and Health Sciences (AMHS)
Vol. 2 No. 2 (2023): ACTA Medical Health Sciences

Relationship between D-dimer level and severity in COVID-19 cases at Dustira Hospital

Roslaeni, Rini (Unknown)
N Nawangsih, Eka (Unknown)
Judarisa, Tristy (Unknown)



Article Info

Publish Date
31 Oct 2023

Abstract

Coronavirus Disease-2019 (COVID-19) is an emerging disease with clinical symptoms similar to severe pneumonia. It is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). COVID-19 encompasses various degrees of severity, including mild, moderate, severe, and critical. One of the supporting tests used to detect COVID-19 is the D-dimer test. This cross-sectional study aims to investigate the relationship between D-dimer levels and the severity of COVID-19. The study was conducted at Dustira Hospital in West Java, Indonesia, from September 2022 to January 2023. D-dimer examination utilizes the Sysmex CS-2500 instrument, with a reference value of <0.5 mg/L. A sample of 42 patients was selected using the purposive sampling technique. The results revealed that the majority of confirmed COVID-19 cases were female (59.5%), with the highest proportion in the age groups of 41-50 years and 51-60 years (33.3%). Among the patients, 52.4% had moderate severity, and 64.3% had increased D-dimer levels. The average D-dimer levels in patients with moderate, severe, and critical symptoms were 0.97 mg/L, 2.33 mg/L, and 4.35 mg/L, respectively. The data were analyzed using the Kruskal-Wallis test, which indicated a significant difference in D-dimer levels based on the severity of COVID-19 (p=0.0001). Elevated D-dimer levels occur as a result of SARS-CoV-2 infection, which triggers an exaggerated inflammatory response leading to a cytokine storm. This, in turn, causes endothelial cell dysfunction and stimulates an excessive immune response, resulting in immune cells attacking healthy tissue. The severity of symptoms worsens as the D-dimer level increases. DOI : 10.35990/amhs.v2n2.p81-87 REFERENCE World Health Organization. WHO Official COVID-19 Info [Internet]. 2022 [cited 2022 Jul 17]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 Magdalena, Sugiri YJ, Tantular R, Listyoko A. Karakteristik Klinis Pasien COVID-19 di Rumah Sakit Dr. Saiful Anwar, Malang. J Respirol Indones. 2021;41(1):7–14. Susilo A, Rumende CM, Pitoyo CW, Santoso WD, Yulianti M, Herikurniawan H, et al. Coronavirus Disease 2019: Tinjauan Literatur Terkini. J Penyakit Dalam Indones. 2020;7(1):45–67. Kementerian Kesehatan RI. Peta Sebaran Transmisi Lokal dan Wilayah Terkonfirmasi [Internet]. [cited 2022 Jul 18]. Available from: https://infeksiemerging.kemkes.go.id/dashboard/covid-19 Burhan E, Susanto AD, Nasution SA, Eka G, Pitoyo Ceva W, Susilo A, et al. Pedoman Tatalaksana COVID-19. 4th ed. Jakarta: 2022. p. 1–10. Willim HA, Hardigaloeh AT, Supit AI. Koagulopati pada Coronavirus Disease-2019 (COVID-19): Tinjauan pustaka. Intisari Sains Medis. 2020;11(3):749–56. Akbar MNA, Rahardjo AM, Parti DD, Sakinah EN. Analisis Hubungan NLR, D-dimer dan Saturasi Oksigen dengan Derajat Keparahan COVID-19 di RSU Kaliwates Jember. J Agromed Med Sci. 2022;8(1):51–5. 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):2–11. Nemec HM, Ferenczy A, Iii BDC, Ashley DW, Montgomery A. Correlation of D-dimer and Outcomes in COVID-19 Patients. Am Surg. 2022;88:2115–8. Afandi D. Kaidah dasar bioetika dalam pengambilan keputusan klinis yang etis. Majalah Kedokteran Andalas. 2017;40(2):111–21. Centers for Disease Control and Prevention. Provisional COVID-19 Deaths by Sex and Age. 2023. Neves MT, de Matos LV, Vasques AC, Sousa IE, Ferreira I, Peres S, et al. COVID-19 and aging: Identifying measures of severity. SAGE Open Med. 2021;9:1–6. Liu Y, Mao B, Liang S, Yang JW, Lu HW, Chai YH, et al. Association between age and clinical characteristics and outcomes of COVID-19. Eur Respir J. 2020;55(5). Kurnianto E, Putra DH, Fannya P, Dewi DR. Tinjauan karakteristik pasien dengan kasus positif COVID-19 di Puskesmas Kecamatan Matraman. Indones Health Inf Manag J. 2021;9(2):102–8. Khaerunnisa R, Rumana NA, Yulia N, Fannya P. Gambaran Karakteristik Pasien COVID-19 di Rumah Sakit Mekar Sari Bekasi Tahun 2020–2021. J Manaj Inf Kesehat Indones. 2022;10(1):72. Berger JS, Kunichoff D, Adhikari S, Ahuja T, Amoroso N, Aphinyanaphongs Y, et al. Prevalence and Outcomes of D-Dimer Elevation in Hospitalized Patients With COVID-19. 2020;(Oct):2539–47. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–7. Roslaeni R. Telaah Pustaka: D-Dimer Pada Pasien COVID-19. Med Kartika. 2022;5(3):332–42. Atmaja KS, Wicaksana AAGOS, Putra IWAS, Putra WWS. Hubungan konsentrasi serum C-Reactive Protein dan D-dimer dengan derajat keparahan dan mortalitas pasien COVID-19. Intisari Sains Medis. 2021;12(2):680. Ardiani S, Tursinawati Y, Wahab Z. Hubungan D-Dimer dengan Ketahanan Hidup Pasien Covid-19 Derajat Berat-Kritis di RSUD Tugurejo Semarang. Health Med J. 2022;5(1):44–9.

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Journal Info

Abbrev

acta_medica

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

Description

Acta Medical and Health Sciences (AMHS) is a scientific journal that publishes research articles, case reports, literature reviews, and other topics relevant to the field of medicine and health, either clinically or to the biomolecular level. Manuscript under consideration that may be uploaded is a ...