D-dimer correlation as a marker of coagulopathy with neuroimaging abnormalities on head CT scans of COVID-19 patients

Abstract

Background: COVID-19 is a coronavirus disease with the main symptoms in the respiratory tract which can cause hypoxia. The duration and severity of the hypoxia can lead to oxidative stress that can affect the brain. The phenomenon of thromboembolism was also found in the form of an increase in coagulopathy markers which can cause abnormalities in small blood vessels in various organs, including the brain. Methods: We conducted a prospective crossectional study of 23 samples that met the inclusion criteria. Duration of hypoxia, degree of hypoxia based on oxygen saturation, and D-Dimer level as independent variables underwent Spearman correlation test with neuroimaging abnormalities on head CT scan. Results: The sample population consisted of 14 men (60.90%) and 9 women (39.10%), with the highest age group being 61 – 80 years old (56.50%) who underwent a head CT scan without contrast administration. Eighteen samples were found to have brain infarction, while 5 samples were without abnormalities. The Spearman correlation test found a correlation (p=0.003) with moderate correlation (r=0.558) between the D-Dimer level as a coagulopathy marker and abnormal findings on the head CT scan of samples. Where 15 samples with high D-Dimer levels (D-Dimer values above the normal level) and 3 samples with normal D-Dimer levels were found to have brain infarction. Meanwhile, the duration and degree of hypoxia based on the oxygen saturation value did not show a significant correlation with neuroimaging abnormalities (p>0.05). Conclusion: There was a moderate correlation between the D-Dimer value. No significant correlation was found between the duration of hypoxia and the degree of oxygen saturation toward neuroimaging abnormalities in COVID-19 patients.