VPB0120 - D-Dimer Levels at Admission for Predicting In-Hospital Mortality in COVID-19 Patients

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Visakha Revana Irawan, MD

Internal Medicine Resident
Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University / Prof. dr. R. D. Kandou General Hospital, Manado, Indonesia
Manado, Sulawesi Utara, Indonesia

Co-Author(s)

LR

Linda Wilhelma Ancella Rotty

Hematologist - Oncologist (Internist)
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University / Prof. dr. R. D. Kandou General Hospital, Manado, Indonesia
Manado, Sulawesi Utara, Indonesia
PL

Pearla Fidei Cindy Lasut

Hematologist - Oncologist (Internist)
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University / Prof. dr. R. D. Kandou General Hospital, Manado, Indonesia
Manado, Sulawesi Utara, Indonesia
CH

Cecilia Andalina Hendratta

Hematologist - Oncologist (Internist)
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University / Prof. dr. R. D. Kandou General Hospital, Manado, Indonesia
Manado, Sulawesi Utara, Indonesia
HH

Harlinda Haroen

Hematologist - Oncologist (Internist)
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University / Prof. dr. R. D. Kandou General Hospital, Manado, Indonesia
Manado, Sulawesi Utara, Indonesia

Background: Coronavirus disease 2019 (COVID-19) has been associated with coagulation abnormalities. In achieving optimal patient management, early and effective markers are needed to predict the patient's clinical outcome, especially in areas with high incidence rates.

Aims: We aimed to determine an optimal cutoff level of NLR for predicting in-hospital mortality in COVID-19 patients in Indonesia.

Methods: We conducted a retrospective cohort study. We enrolled adult patients with confirmed RT-PCR COVID-19 who were hospitalized in the Prof. dr. R. D. Kandou General Hospital from October 2020 to June 2021. D-dimer levels at admission and death event were collected and analyzed using ROC curves to determine the optimal cutoff level of D-dimer to predict in-hospital mortality.

Results: D-dimer elevation (≥ 0.50 μg/mL) was obtained in 83.1% among 451 patients hospitalized with COVID-19. The optimum cutoff D-dimer level to predict in-hospital mortality was 3.15 μg /mL with a sensitivity 67.39% and a specificity of 73.54%. There were 157 patients (34.81%) with D-dimer ≥ 3.15 µg/mL, and 294 patients (65.19%) with D-dimer < 3.15 µg/mL on admission. Median of D-dimer level among survivors was 1.5 µg/mL and among non-survivors was 6.52 µg/mL. Patients with D-dimer levels ≥ 3.15 µg/mL had a higher incidence of mortality when comparing with those who with D-dimer levels < 3.15 µg/mL (OR = 5.72, 95% CI (3.488 – 9.386), p = 0.0001).

Conclusion(s): D-dimer level ≥ 3.15 µg/mL at admission could effectively predict in-hospital mortality COVID-19 patients in Indonesia. D-dimer level could be the early and effective marker for COVID-19 patients.