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Asian Journal of Medical Sciences ; 14(2):16-21, 2023.
Article in English | Academic Search Complete | ID: covidwho-2228136


Background: Coronavirus disease 2019 (COVID-19) is a RNA virus which infects both human beings and animals. COVID-19 infection is presently a very important, global health related problem. It is contagious. The COVID-19 or severe acute respiratory syndrome (SARS)-CoV-2 virus affects the lungs very commonly through the angiotensin converting enzyme 2 receptor which is present in abundance on the surface of type II alveolar cells. It leads to SARS. The severely ill COVID-19 patients suffer from massive intra vascular clot formation. Therefore, coagulation tests are very useful to assess the severity of the cases. Aims and Objectives: The aim of our study is to assess, that whether by examining the blood of a COVID-19 patient for D-Dimer, the treating physician can judge the severity of the case and come to a conclusion regarding the line of management. Materials and Methods: This is a retrospective study conducted in the departments of Pathology and Radiology of RG Kar Medical College. Records of the patients who were admitted for COVID-19, from September 2020 to September 2021, have been studied for their D dimer levels. The computed tomography (CT) scan findings of the respective patients have also been studied from the departmental records. Results: In our study, the median value of D-Dimers of 80 samples came out to be 1.4. (1) CT scores, (2) presence or absence of crazy paving sign, and (3) perilobular fibrosis in CT scan have been studied and compared with the median D Dimer values. It has been seen from our study that out of 54 cases whose D-Dimers were <1.4, 41 cases had moderate CT score, and 13 had CT score in the severe range, 26 cases had crazy paving sign in their CT findings, and 28 cases did not show crazy paving sign in their CT findings, and 22 cases had perilobular fibrosis in their CT reports, and 32 cases did not have perilobular fibrosis. The P-values came out to be <0.05 for all the three parameters. Conclusion: We concluded from the study that D-Dimer levels can reflect the severity of lung parenchymal injury and can be used to judge the severity and to plan the line of management of COVID cases. [ FROM AUTHOR]

J Anaesthesiol Clin Pharmacol ; 38(Suppl 1): S89-S95, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2024774


Background and Aims: The hypercoagulability occurring in COVID-19 patients is detected only by Rotational thromboelastometry (ROTEM). However, the benefit of performing ROTEM in the management of disease and predicting the outcome of COVID-19 patients is yet to be established. Material and Methods: The data of 23 critically ill and 11 stable COVID-19 adult patients were extracted from the hospital information system admitted between July and August 2020 and patient charts and analyzed retrospectively. The critically ill patients were divided as a survivor and non-survivor groups. The Intrinsic pathway part of ROTEM (INTEM) and Fibrinogen part of ROTEM (FIBTEM) were performed on day 0 for both critically ill and stable patients, and on day 10 for critically ill patients. The statistical package for social science (SPSS) version 26 was used for statistical analysis. Results: The median FIBTEM amplitude at 5 min (A5) and maximum clot firmness (MCF) were elevated in both stable and critically ill patients (24 vs 27 mm, P = 0.46 and 27.5 vs 40 mm, P = 0.011) with a significant difference in FIBTEM MCF. But there was no significant difference between number of survivors and non-survivors with FIBTEM MCF >25 at day 0 and day 10. Conclusion: The Hypercoagulability state as detected by ROTEM parameters at day 0 and day 10 had no association with the outcome (mortality) of critically ill COVID-19 patients. Hence it cannot be used as a prognostic test. The increasing age, comorbidities and D-dimer values were associated with a poor prognosis in COVID-19 patients.

Clinical and Applied Thrombosis-Hemostasis ; 27:13, 2021.
Article in English | Web of Science | ID: covidwho-1582642
Int J Infect Dis ; 100: 441-448, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-758908


BACKGROUND: To determine whether abnormal coagulation parameters are associated with disease severity and poor prognosis in patients with 2019 Corona Virus Disease (COVID-19). METHODS: A systematic literature search was conducted using the databases PubMed, Embase, and Web of sciences until April 25, 2020. We included a total of 15 studies with 2277 patients. Platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (D-D), and fibrinogen (FIB) were collected and analyzed. The statistical results were expressed as the effect measured by mean difference (MD) with the related 95% confidence interval (CI). RESULTS: The PLT level of severe cases was lower than that of mild cases, while the levels of PT, D-D, and FIB were higher than those of mild cases (P < 0.05). The level of APTT had no statistical difference between two groups (P > 0.05). PT of ICU patients was significantly longer (P < 0.05) than that of non-ICU patients. In non-survivors, PT and D-D were higher, yet PLT was lower than that of survivors (P < 0.05). There was no significant difference in APTT between survivors and non-survivors (P > 0.05). The funnel plot and Egger's regression test demonstrated that there was no publication bias. CONCLUSIONS: Our data support the notion that coagulopathy could be considered as a risk factor for disease severity and mortality of COVID-19, which may help clinicians to identify the incidence of poor outcomes in COVID-19 patients.

Betacoronavirus , Blood Coagulation , Coronavirus Infections/blood , Pneumonia, Viral/blood , COVID-19 , Coronavirus Infections/mortality , Cross-Sectional Studies , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Pandemics , Partial Thromboplastin Time , Pneumonia, Viral/mortality , Prognosis , Prothrombin Time , SARS-CoV-2 , Severity of Illness Index