D-dimer: A Marker of Severity in COVID-19

Introduction: The ever-growing number of COVID-19 patients stresses upon the need to identify effective yet readily available predictors of disease severity to ensure better clinical outcomes. D-dimer is a fibrin specific degradation product derived by enzymatic action of plasmin on factor XIIIa cross-linked fibrin. It serves as an ideal marker for activation of coagulation and fibrinolytic pathways. Identification of coagulopathy as an important complication in COVID-19 patients has brought to focus D-dimer as a possible predictor of clinical severity in patients. Aim: In this study, we analysed the role of D-dimer levels in assessing the clinical severity of the COVID-19 patients. Materials and Methods: We enrolled 217 in-patients of Tirunelveli Medical College in this single centre observational study and classified them into asymptomatic, mild, moderate and severe according to “Clinical Management Protocol: COVID 19”, by the Ministry of Health and Family Welfare and Director General of Health Services. D-dimer was estimated in the separated plasma, using latex based assay using semi-automated coagulation analyser. Data were presented as percentages for categorical variables and median±Inter Quartile Range (IQR) for continuous variables. Chi-square test was used to compare the D-dimer values between symptomatic and asymptomatic groups. A value of p