Coagulation profile and correlation between D-dimer, inflammatory markers, and COVID-19 severity in an Indonesian national referral hospital

Abstract

Background: Coagulopathy and inflammation are associated with coronavirus disease 2019 (COVID-19) severity. This study assessed D-dimer concentration and its correlation with inflammatory markers and COVID-19 severity. Methods: This was a retrospective cross-sectional study involving 194 COVID-19 cases, with the severity of infection graded in accordance with the World Health Organization (WHO) guidelines. We measured D-dimer, C-reactive protein (CRP), and ferritin on admission and determined the cutoff values for D-dimer and CRP and evaluated the correlation between D-dimer and CRP and ferritin. Results: Median D-dimer, CRP, and ferritin concentrations were 2240 µg/L, 73.2 mg/L, and 1173.8 µg/mL, respectively. The highest median D-dimer value was seen in mild and moderate acute respiratory distress syndrome (ARDS). The highest ferritin concentration was seen in severe ARDS. There was a significant correlation between D-dimer value and CRP (r = 0.327), but no significant correlation between D-dimer and ferritin (r = 0.101). The area under the receiver operating characteristic curve (AUC) for the combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L as a marker of COVID-19 severity was 0.722 (95% confidence interval (CI): 0.615–0.781). Conclusion: The combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L can be used as marker of COVID-19 severity, with moderate accuracy.