Increase in requests for D-dimer in the first wave of COVID-19 in a university hospital in the metropolitan region of the State of Rio de Janeiro

Authors

DOI:

https://doi.org/10.33448/rsd-v10i14.21666

Keywords:

Fibrinolysis; Dimer; Pandemic.

Abstract

Introduction: D-dimer is a fibrin degradation product and is an indirect marker of fibrinolysis. If an individual infected with SARS-COV 2 evolves with aggravation, a result equal to or greater than four times the reference value of this marker at the time of admission is considered a predictor of mortality. The most important exam since the beginning of the pandemic, due to the thrombotic manifestations resulting from the infection. Objective: To evaluate the variation in the number of medical requests for D-dimer dosage at a given University Hospital and its profile in the first wave of the COVID-19 pandemic. Methodology: This is a cross-sectional observational study, where the results of patients with a COVID-19 profile, identified in the Emergency Laboratory of a University Hospital, were quantified and medical causes for D-dimer dosages in the period from 03/01/2020 to 07/03/2020. Results: In the first half of 2020, we observed 1017 requests. Comparing the 1st quarter with the 2nd quarter of the same year, there was an abrupt increase of 1274%, no total occurrences from one quarter to the other, since no 1st quarter, only 69 requests were detected with a median 2231 ng / mL ( interquartile range 175-15605), no longer 2nd quarter this number jumped to a total of 948 requests with a median 2020 ng / mL (interquartile range 99-97026). Conclusion: Although D-dimer does not have high specificity as a diagnostic tool, it has been very useful as a severity predictor for COVID 19. Despite the enormous impact generated by the substantial increase in demand for D-dimer demand in this University Hospital, have provoked a solution of continuity in the provision of services, further studies in risk and disaster management would be opportune, in order to improve the resolving flow for situations that, unfortunately, may occur.

Author Biographies

Paulo Sérgio de Abreu Junior, Universidade Federal Fluminense

Diretor autor.

Suelen Brito Nascimento, Universidade Federal Fluminense

Revisões e correções em geral.

Sara Nascimento, Universidade Federal Fluminense

Confecção de tabelas em dados brutos.

Gabriel Dourado, Universidade Federal Fluminense

Confecção de tabelas em dados brutos.

Marianna Gomes, Universidade Federal Fluminense

Confecção de tabelas em dados brutos.

Jenifer Pereira Vitoriano, Universidade Federal Fluminense

Compilação de dados brutos.

Iasmin Cardoso Fonseca, Universidade Federal Fluminense

Coleta de dados brutos.

Hye Chung Kang, Universidade Federal Fluminense

Revisão e supervisão geral.

References

BRASIL, M. da S. (2020). Protocolo de Manejo Clínico da Covid-19 na Atenção Especializada. In Ministério da Saúde.

Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qiu, Y., Wang, J., Liu, Y., Wei, Y., Xia, J., Yu, T., Zhang, X., & Zhang, L. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, 395(10223), 507–513. https://doi.org/10.1016/S0140-6736(20)30211-7

Connors, J. M., & Levy, J. H. (2020). COVID-19 and its implications for thrombosis and anticoagulation. Blood, 135(23), 2033–2040. https://doi.org/10.1182/BLOOD.2020006000

Cunningham, A. C., Goh, H. P., & Koh, D. (2020). Treatment of COVID-19: Old tricks for new challenges. In Critical Care (Vol. 24, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s13054-020-2818-6

Debuc, B., & Smadja, D. M. (2021). Is COVID-19 a New Hematologic Disease? Stem Cell Reviews and Reports, 17(1), 4–8. https://doi.org/10.1007/s12015-020-09987-4

Lúcia, M. da R. S. P. (2005). Universidade Federal do Rio Grande do Sul Faculdade de Medicina Programa de Pós-Graduação em Medicina: Ciências Médicas Associação entre os níveis de D-dímero, produtos de degradação da fibrina/fibrinogênio (PDF) e troponina cardíaca T na investigação dos distúrbios tromboembólicos RAFAEL NOAL MORESCO.

Gabbai‐Armelin, P. R., Oliveira, A. B., Ferrisse, T. M., Sales, L. S., Barbosa, E. R. O., Miranda, M. L., Salomão, K. B., & Brighenti, F. L. (2021). COVID‐19 (SARS‐CoV‐2) infection and thrombotic conditions: A systematic review and meta‐analysis. European Journal of Clinical Investigation. https://doi.org/10.1111/eci.13559

Hanff, T. C., Mohareb, A. M., Giri, J., Cohen, J. B., & Chirinos, J. A. (2020). Thrombosis in COVID-19. In American Journal of Hematology (Vol. 95, Issue 12, pp. 1578–1589). Wiley-Liss Inc. https://doi.org/10.1002/ajh.25982

Harper, P. L., Theakston, E., Ahmed, J., & Ockelford, P. (2007). D-dimer concentration increases with age reducing the clinical value of the D-dimer assay in the elderly. Internal Medicine Journal, 37(9), 607–613. https://doi.org/10.1111/j.1445-5994.2007.01388.x

Higuera-de-la-Tijera, F., Servín-Caamaño, A., Reyes-Herrera, D., Flores-López, A., Robiou-Vivero, E. J. A., Martínez-Rivera, F., Galindo-Hernández, V., Rosales-Salyano, V. H., Casillas-Suárez, C., Chapa-Azuela, O., Chávez-Morales, A., Jiménez-Bobadilla, B., Hernández-Medel, M. L., Orozco-Zúñiga, B., Zacarías-Ezzat, J. R., Camacho, S., & Pérez-Hernández, J. L. (2021). The Age-AST-D Dimer (AAD) Regression Model Predicts Severe COVID-19 Disease. Disease Markers, 2021, 6658270. https://doi.org/10.1155/2021/6658270

Jin, J. M., Bai, P., He, W., Wu, F., Liu, X. F., Han, D. M., Liu, S., & Yang, J. K. (2020). Gender Differences in Patients With COVID-19: Focus on Severity and Mortality. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.00152

Johnson, E. D., Schell, J. C., & Rodgers, G. M. (2019). The D-dimer assay. American Journal of Hematology, 94(7), 833–839. https://doi.org/10.1002/ajh.25482

Li, Y., Zhao, K., Wei, H., Chen, W., Wang, W., Jia, L., Liu, Q., Zhang, J., Shan, T., Peng, Z., Liu, Y., & Yan, X. (2020). Dynamic relationship between D-dimer and COVID-19 severity. British Journal of Haematology, 190(1), e24–e27. https://doi.org/10.1111/bjh.16811

Moreno, G., Carbonell, R., Bodí, M., & Rodríguez, A. (2021). Systematic review of the prognostic utility of D-dimer, disseminated intravascular coagulation, and anticoagulant therapy in COVID-19 critically ill patients. Medicina Intensiva, 45(1), 42–55. https://doi.org/10.1016/j.medin.2020.06.006

Pereira, A., Shitsuka, D., Parreira, F., & Shitsuka, R. (2018). Método Qualitativo, Quantitativo ou Quali-Quanti. In Metodologia da Pesquisa Científica. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.

Quacken, F., Greiffendorf, I., Ropertz, S., Peters, D., Bergrath, S., Aretz, S., Lahm, A., Pesch, A., Wimmer-Dahmen, M.-L., & Graeven, U. (2021). [Hospital inhouse contact tracing-significant impact to patient care during the coronavirus pandemic]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. https://doi.org/10.1007/s00103-021-03330-z

Rahi, M. S., Jindal, V., Reyes, S. P., Gunasekaran, K., Gupta, R., & Jaiyesimi, I. (2021). Hematologic disorders associated with COVID-19: a review. Annals of Hematology, 100(2), 309–320. https://doi.org/10.1007/s00277-020-04366-y

Rostami, M., & Mansouritorghabeh, H. (2020). D-dimer level in COVID-19 infection: a systematic review. In Expert Review of Hematology (Vol. 13, Issue 11, pp. 1265–1275). Taylor and Francis Ltd. https://doi.org/10.1080/17474086.2020.1831383

Velicu, M. A., Furlanetti, L., Jung, J., & Ashkan, K. (2021). Epidemiological trends in COVID-19 pandemic: Prospective critical appraisal of observations from six countries in Europe and the USA. BMJ Open, 11(4), 1–9. https://doi.org/10.1136/bmjopen-2020-045782

Weitz, J. I., Fredenburgh, J. C., & Eikelboom, J. W. (2017). A Test in Context: D-Dimer.

WHO. (2010). Relatório Mundial de Saúde - Financiamento dos Sistemas de Saúde. O capminho para a cobertura universal. Relatório Mundial Da Saúde, 1–143.

Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S., Huang, H., Zhang, L., Zhou, X., Du, C., Zhang, Y., Song, J., Wang, S., Chao, Y., Yang, Z., Xu, J., Zhou, X., Chen, D., Xiong, W., & Song, Y. (2020). Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine, 180(7), 934–943. https://doi.org/10.1001/jamainternmed.2020.0994

Zhang, L., Yan, X., Fan, Q., Liu, H., Liu, X., Liu, Z., & Zhang, Z. (2020). D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. Journal of Thrombosis and Haemostasis, 18(6), 1324–1329. https://doi.org/10.1111/jth.14859

Published

31/10/2021

How to Cite

ABREU JUNIOR, P. S. de; NASCIMENTO, S. B. .; NASCIMENTO, S.; DOURADO, G.; GOMES, M.; VITORIANO, J. P. .; FONSECA, I. C. .; KANG, H. C. . Increase in requests for D-dimer in the first wave of COVID-19 in a university hospital in the metropolitan region of the State of Rio de Janeiro. Research, Society and Development, [S. l.], v. 10, n. 14, p. e148101421666, 2021. DOI: 10.33448/rsd-v10i14.21666. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/21666. Acesso em: 18 apr. 2024.

Issue

Section

Health Sciences