Serum D-dimer and C-reactive Protein Levels in Mild, Moderate and Severe COVID-19 Patients

Abstract

Background: The COVID-19 pandemic, caused by severe acute respiratory syndrome corona virus 2 (SARS-COV-2), typically spreads via respiratory droplets and during close contact. The main clinical manifestation is lung injury. Most of the patients have favorable prognosis, but in some cases it rapidly progresses to severe and critical forms with respiratory distress syndrome, coagulation dysfunction, septic shock, metabolic acidosis, multiorgan failure etc. Therefore, early detection of the severity is very important for the clinical management and treatment of COVID-19 patients. Commonly used clinical laboratory coagulation indices are D-dimer and CRP (C-reactive protein) to assess ongoing inflammation. Objective: To investigate any alteration of serum D-dimer and CRP levels in mild, moderate and severe COVID-19 patients. Materials and Methods: This cross sectional study was carried out in the Department of Biochemistry, Dhaka Medical College & Hospital, Dhaka during the period of January 2020 to December 2020. A total of 80 subjects were selected, who were diagnosed as COVID-19 confirmed by RT-PCR with the age ranging from 18−65 years (both male and female) from the COVID unit of Dhaka Medical College Hospital, Dhaka. These diagnosed COVID-19 patients were divided into three groups─mild (Group A₁), moderate (Group A₂) and severe (Group A₃). Forty age and gender matched non-COVID admitted individuals in medicine department of Dhaka Medical College Hospital, Dhaka were enrolled as comparison group (Group B).  Informed written consents were taken from the study subjects, relevant physical examinations were done and venous blood samples were collected for estimation of serum D-dimer and CRP levels. The results were compared statistically among groups. Results:  There were increase in the serum D-dimer and CRP levels in COVID-19 patients but the serum D-dimer and CRP levels were significantly increased in severe COVID-19 patients when compared with mild and moderate groups. Conclusion: The findings suggest that D-dimer and CRP levels can be used to detect the severity of COVID-19 patients.

J Enam Med Col 2023; 13(2): 48-55