Relationship between D-dimer and C-reactive protein Levels with the Disease Severity in COVID-19 Patients at Mataram University Hospital

  • Sang Ayu Nyoman Putri Pradnyasari Fakultas Kedokteran Universitas Mataram
  • Moulid Hidayat Fakultas Kedokteran Universitas Mataram
  • Prima Belia Fathana Fakultas Kedokteran Universitas Mataram
Keywords: COVID-19, D-dimer, CRP, Disease severity

Abstract

Background: Coronavirus disease 19 (COVID-19) is an acute respiratory infectious disease by SARS-CoV-2. This disease was discovered in Wuhan, China. In some cases, COVID-19 can be life-threatening due to an uncontrolled inflammatory phase characterized by increased levels of D-dimer and C-reactive protein (CRP) in the body. This condition can lead to complications such as ARDS, shock, and even death. This study aims to determine the relationship between D-dimer and CRP levels with the disease severity in COVID-19 patients at the Mataram University Hospital.

Methods: This study is an observational analytic study with a cross-sectional design. Data collection took place in March-May 2022 at the Mataram University Hospital. Subjects were selected using consecutive sampling methods through medical record data. The statistical test used the Chi-square and Mann-Whitney comparative tests.

Results: A total of 64 subjects were selected, of which 48 subjects underwent a D-dimer examination and 58 underwent a CRP examination. Most subjects were in the age group 18-59 years (64.1%), with the male gender (56.3%). There were 10 subjects (20.8%) had normal D-dimer levels, and 38 subjects (79.2%) had elevated D-dimer levels. Normal CRP levels were found in 6 subjects (10.3%), and 52 subjects (89.7%) had elevated CRP levels. The results of the bivariate test analysis showed p-value = 0.002 for D-dimer levels with severe symptoms, and CRP levels with severe symptoms showed p-value = 0.02.

Conclusion: There is a significant correlation statistically and clinically between D-dimer and C-reactive protein levels with the disease severity in COVID-19 patients.

References

1. Cascella, M. et al. (2020) ‘Features, Evaluation, and Treatment of Coronavirus’, in StatPearls, p. 19. Available at: http://www.ncbi.nlm.nih.gov/pubmed/32150360.
2. Berhandus, C., Ongkowijaya, J. A. and Pandelaki, K. (2021) ‘Hubungan Kadar Vitamin D dan Kadar C-reactive protein dengan Klinis Pasien Coronavirus Disease 2019’, e-CliniC, 9(2), p. 370. doi: 10.35790/ecl.v9i2.33043.
3. Potempa, L. A. et al. (2020) ‘Insights into the use of C-reactive protein as a diagnostic index of disease severity in COVID-19 infections’, American Journal of Tropical Medicine and Hygiene, 103(2), pp. 561–563. doi: 10.4269/ajtmh.20-0473.
4. Huang, I. et al. (2020) ‘C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis’, Therapeutic Advances in Respiratory Disease, 14, pp. 1–14. doi: 10.1177/1753466620937175.
5. Hidayat, M. et al. (2021) ‘Hyperinflammation syndrome in covid-19 disease: Pathogenesis and potential immunomodulatory agents’, Turkish Journal of Immunology, 9(1), pp. 1–11. doi: 10.5222/TJI.2021.92486.
6. Yu, B. et al. (2020) ‘Evaluation of variation in D?dimer levels among COVID?19 and bacterial pneumonia: a retrospective analysis’, Journal of Thrombosis and Thrombolysis. Available at: https://doi.org/10.1007/s11239-020-02171-y.
7. Bao, W. et al. (2017) ‘Correlation of D-dimer level with the inflammatory conditions: a retrospective study’, AME Medical Journal, 2, pp. 27–27. doi: 10.21037/amj.2017.02.07.
8. Wang, L. (2020) ‘C-reactive protein levels in the early stage of COVID-19’, Elsevier Public Health Emergency Collection, 4(January), pp. 332–334.
9. Liu T, et al. (2020) ‘The role of interleukin-6 in monitoring severe case of coronavirus disease 2019’. EMBO Mol Med. 2020 Jul 7;12(7):e12421. doi: 10.15252/emmm.202012421. Epub 2020 Jun 5. PMID: 32428990; PMCID: PMC7280589.
10. Kasita, S. E. et al. (2022) ‘Gambaran Diagnostik dan Penatalaksanaan COVID-19 pada Pasien Lansia di RSU Royal Prima Medan’, Jambura Journal, 4 (1) pp. 461-468.
11. Atmaja, K. S. et al. (2021) ‘Hubungan konsentrasi serum C- Reactive Protein dan D-dimer dengan derajat keparahan dan mortalitas pasien COVID-19’, Intisari Sains Medis, 12(2), pp. 680–685. doi: 10.15562/ism.v12i2.971.
12. Smilowitz, N. R. et al. (2021) ‘C-reactive protein predicts outcome in COVID-19: is it also a therapeutic target?’, European heart journal, 42(23), pp. 2280–2283. doi: 10.1093/eurheartj/ehab169.
13. Permana, A., Yari, C. E. and Aditya, A. K. (2021) ‘Gambaran D-Dimer Dan Limfosit Pada Pasien Terkonfirmasi Covid-19 Di RS Haji Jakarta’, Anakes?: Jurnal Ilmiah Analis Kesehatan, 7(1), pp. 62–71. doi: 10.37012/anakes.v7i1.523.
14. Ortega-Paz, L. et al. (2021) ‘Coronavirus disease 2019–associated thrombosis and coagulopathy: Review of the pathophysiological characteristics and implications for antithrombotic management’, Journal of the American Heart Association, 10(3), pp. 1–24. doi: 10.1161/JAHA.120.019650.
Published
2022-12-30