77. ASSOCIATION OF D-DIMER AND FIBRINOGEN LEVEL WITH MORTALITY OF HYPERTENSIVE COVID-19 PATIENTS

Abstract

Background: Hypertension is the most evident comorbid in Covid-19. Thromboembolism, arguably the most thrilling pathomechanism in Covid-19. D-dimer and fibrinogen are parameters to describe thromboembolism but still need a real-world data about its association with mortality in hypertension. Objective: To explore association of D-dimer and fibrinogen level with mortality in hypertensive and non hypertensive Covid-19 patients Methods: This is a cross sectional retrospective study. Subjects were confirmed Covid-19 patients above 18 years old in RSUP Prof. Dr. R.D. Kandou Manado within last 5 months with D-dimer and fibrinogen examination. Data were analyzed using Mann-Whitney and Chi-square method. Results: There were 178 patients, male 93 (52%), female 85 (47.8%), average 52.71 ± 15.30 years old, 100 (56.2%) hypertensive and 78 (43.8%) non hypertensive patients. Among hypertensive patients, 18 (35.3%) with elevated D-dimer and 14 (28%) with elevated fibrinogen did not survive, compared to 4 (10.3%) and 3 (7.7%) in non-hypertensive patients. There was significant association between D-dimer and mortality in hypertensive patients (PR = 3.46, 95% CI 1.39–8.59; p = 0.003, Median 1.65) and significant differences of D-dimer and fibrinogen level in hypertensive and non-hypertensive (1.65 IQR 3.13 vs. 0.44 IQR 0.79; p = 0.0001, 560 IQR 302.5 vs. 430 IQR 200; p = 0.0001). There was no significant difference of outcome regarding anti-coagulant injection. Conclusion: Mortality was about 3 times higher in hypertensive patients with high D-dimer. This study revealed to us that D-dimer potentially a mortality predictor in hypertensive Covid-19 patients.