The Effectiveness of Platelet and D-Dimer Levels in Predicting Prognosis in Intensive Care Patients Diagnosed With COVID-19

Abstract

Background: The pathophysiology of coagulopathy in patients with Corona virus disease 2019 (COVID-19) and its clinical manifestations remain unclear. However, several studies have reported abnormal coagulation parameters, notably in patients with COVID-19 associated pneumonia and acute respiratory distress syn-drome. Although the underlying mechanism of COVID-19 coagulopathy remains unknown, it has been sug-gested to be a form of disseminated intravascular coagulation. We aimed to determine the predictive value of platelet count and D-dimer levels in predicting prognosis in intensive care patients with a diagnosis of COVID-19.Materials and Methods: Demographic, clinical, laboratory data and radiological findings were obtained from the hospital electronic patient record using a standard data collection form. Platelet counts and D-dimer data were noted. Intensive care stay, mechanical ventilator duration and hospital stay of the patients were ana-lyzed retrospectively. Clinical data covers also comorbid conditions.Results: The study included 102 intensive care patients with COVID-19 diagnosis. All the patients had Poly-merase Chain Reaction (PCR) confirmation and abnormalities on chest computed tomography (CT) consistent with COVID-19. Bilateral pneumonia proven by chest CT was reported in 91.2% of the patient. The platelet count of patients who died was median 247x109 /L (min-max 192 - 354), D dimer levels was median 7.03 (min-max 3.36-17.7) mg/L. Patients who living were platelet counts median 310 x109/L (min-max 234 – 350), D-dimer levels median 1.59 (min-max 0.82 -2). There was no statistically significant difference when the platelet count of the survived and deceased patients were compared (p=0.193). But the patients who died was D-dimer levels statistically higher (p=0.001).Conclusions: High or non-decreasing D-dimer levels may indicate poor prognosis in patients with COVID-19 pneumonia whereas platelet counts don’t have a predictive value.