Online ISSN: 2515-8260

Keywords : D-dimer


Correlating inflammatory markers with clinical profile and final outcome in patients with Covid 19 admitted to a tertiary care setup

Dr. Mallikarjun HP,Dr. Ashwin DK,Dr. Ashitha B,Dr. Ramya Bhat S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2296-2303

Background: The ongoing worldwide Coronavirus Disease 2019 (COVID-19) pandemic has posed a huge threat to global public health1. COVID-19 represents a spectrum of clinical severity ranged from asymptomatic to critical pneumonia, acute respiratory distress syndrome (ARDS) and even death. Therefore, full monitoring the severity of COVID-19 and effective early intervention are the fundamental measures for reducing mortality.
Accumulating evidence has suggested that inflammatory responses play a critical role in the progression of COVID-19 3. Inflammatory responses induce the release of cytokines and chemokines. These cytokines and chemokines then attract immune cells and activate immune responses, leading to cytokine storms and aggravations4. Several inflammatory markers have some tracing and detecting accuracy for disease severity and fatality. But the results are inconclusive, with various studies giving different results. Our study intends to correlate levels of inflammatory markers with severity of Covid 19 infection and its final outcome.
Methods and materials:This is a retrospective study which includes 818 patients admitted to our hospital during the second wave of Covid 19 pandemic with confirmed Covid 19 infections by RTPCR. Admitted patients included mild disease to severe Covid 19 infections. Those patients who have received standardized treatment according to hospital protocol were included in the study. Data was collected and entered in pre-designed proforma. Results obtained will be compiled in excel sheet and will be analyzed statistically.
Results: Total of 818 patients were admitted to our hospital between May to July 2021. Of which 341 had mild disease, 241 had moderate disease, 237 patients had severe disease on presentation.While looking into the final outcome of the disease, 175 patients died due Covid 19 pneumonia or its complication, 52 patients were discharged with oxygen support.  Of 237 patients with severe disease 150 patients had CRP levels >75mg/dl. Of 175 patients who died, 121 had CRP levels >75 mg/dl. Of 237 patients with severe disease, 122 of them had D-dimer >1000 ng/ml. Of 175 patients who died with Covid 19, 103 of them had d-dimer levels >1000 ng/ml.CRP and D-dimer were significantly increased in patients with severe disease and in patients who died of Covid 19 with p value <0.0001.
Conclusion: Increasing levels of CRP and D-dimer were good predictors of severe disease in Covid 19. Also, increased levels of CRP and d-dimer were suggestive of poorer outcome of the disease in terms of mortality and morbidity in Covid 19 infection.

Laboratory Markers Versus Ct Severity Score In Predicting Mortality In Covid 19

B.S.Gopala Krishna; P.Pranay Krishna; V.Ravi Sankar; Kondle Raghu; A.Siva Kumar; M. Srikanth; V. Satyanarayana; P. Siri Priya

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1824-1831

Aim: Predicting the mortality of COVID-19 with a spectrum of complications is a difficult task for prognostication and management. When individual level data of COVID-19 patients were not yet available, there is a need for risk predictors to support the treatment decisions. The study aims to identify the high accurate marker to measure the prognosis and outcome of COVID19.
Methods:
COVID-19 course is divided into four stages, according to chest computed tomography (C.T.) progress. The demographics, disease exposure history, clinical condition, laboratory tests, computed tomographic chest scan, and outcome data were collected and measured their correlation to assess the risk predictor.
Results:
The 10.4% mortality (n=52) was observed in total population. D-dimer (μg/dL) levels observed as 0.75 ± 0.65 in expired patients. NLR ratio observed as 17.1 in expired patients. Ferritin levels were observed as 49.8 ± 32.5 in expired patients. A D-dimer positive predictive value of 72.5% and a negative predictive value of 88% for a predictor of mortality. Ferritin positive predictive value of 35.5% and a negative predictive value of 76.5% for the predictor of mortality. Hence, the AUC of serum ferritin 0.598 represents the poor ability to discriminate the prediction for the cause of death than D-dimer levels. D‐dimer > 2 μg/dL on admission was associated with in‐hospital death. These main findings indicate that D‐dimer on admission >2.0 μg/dl was the independent predictor of hospital death in patients with Covid‐19. A D-dimer has the highest positive predictive value than serum ferritin levels.
Conclusion: The AUC for D- dimer at admission was 0.880, with an optimal cutoff of 2.2 μg/dL in predicting the cause of mortality. D‐dimer on admission > 2.0 μg/mL (fourfold increase) is the best predict in‐hospital mortality and a helpful marker to improve the management of Covid‐19.

Assessment of the D-Dimer Levels and their Correlation with Lymph Node Involvement in Carcinoma Breast

Dr. Gaurav Kataria; Dr Preeti Juneja

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 8840-8844

Background:Mammography is a widely used screening approach in the detecting of breast
cancer and proved to help reduce the mortality effectively. D-dimer (or D dimer) is a fibrin
degradation product (or FDP), a small protein fragment present in the blood after a blood
clot is degraded by fibrinolysis. Hence; the present study was undertaken for assessing the
d-dimer levels in carcinoma breast.Materials & methods:A total of 25 breast carcinoma
patients were enrolled.Data was collected using self-structured Performa which consisted
of detailed history, thorough examination, investigations and results. Blood venous
samples (3 ml) were collected from all patients before any surgical intervention, and
clinical staging was done. All the results were recorded and analysed using SPSS software.
Results:Mean D Dimer levels were found to be 2.458 μg/mL.Mean D-Dimer levels among
patients with and without lymph node involvement was 2.896 μg/mL and 1.354 μg/mL
respectively. Significant results were obtained while comparing the mean D-Dimer levels
among patients with and without lymph node involvement.Conclusion:D-dimer was found
to be an independent predictive factor for lymph node metastasis. However; further studies
are recommended.