Relation of D-dimer levels of COVID-19 patients with diabetes mellitus

Mishra, Yogendra; Pathak, Basant Kumar; Mohakuda, Sourya Sourabh; Tilak, Tvsvgk; Sen, Soham; Harikrishnan, Prakash; Singh, Rhea; Singh, Anchit Raj

doi:10.1016/j.dsx.2020.09.035

Cited by 47 publications

(59 citation statements)

References 12 publications

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“…The median D-dimer level in diabetic was found to be 1.68 μg/ml. In a recent publication, Mishra et al have reported an association of diabetes with increased D-dimer levels in moderately sick COVID 19 patients [ 20 ]. Similar to our study, in their study also peak D-dimer levels during the entire course of hospital stay were utilized in statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

D-dimer level is a useful predictor for mortality in patients with COVID-19: Analysis of 483 cases

Soni

Gopalakrishnan

Vaishya

et al. 2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

109

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Background and aims : COVID-19 is a multi-system disease, with coagulation abnormalities. D-dimer levels are increased in this disease. We aimed to determine the association of D-dimer levels and mortality and to establish its optimal cut off values in predicting mortality. Association of D-dimer levels with Diabetes Mellitus has also been established. Methods : Information on 483 patients with confirmed COVID-19 was retrospectively collected and analyzed. The optimal D-dimer cutoff point and C-statistic of routine tests both on admission and during hospital stay were evaluated by receiver operator characteristic (ROC) curve. Results : The D-dimer elevation (≥0.50 μg/mL) was seen in 80.1% of the hospitalized patients. D-dimer level ≥2.01 μg/mL was a significant predictor of subsequent deaths ( P < 0.01; HR, 3.165; 95% CI, 2.013–4.977). The high D-dimer values (≥0.50 μg/mL) were observed in 72 of the 75 (96%) cases with a fatal outcome. Median D-dimer values among non-survivors was 6.34 μg/mL and among survivors it was 0.94 μg/mL. A higher proportion of fatal outcomes occurred in patients with underlying disease (89.0%), most prominent of which was Diabetes Mellitus (66%). The median D-dimer value was found to be significantly high in Diabetic patients (1.68 μg/mL). Conclusions : Among the measured coagulation parameters, D-dimer during hospital stay had the highest C-index to predict in-hospital mortality in COVID-19 patients. D-dimer value ≥ 2.01 μg/mL can effectively predict in-hospital mortality in patients with COVID-19. A significant association of increased D-dimer level has been found with Diabetes Mellitus and elderly age.

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Section: Discussionmentioning

confidence: 99%

D-dimer level is a useful predictor for mortality in patients with COVID-19: Analysis of 483 cases

Soni

Gopalakrishnan

Vaishya

et al. 2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

109

View full text Add to dashboard Cite

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“…D-dimer values are even higher in patients with severe COVID-19 than in those with milder forms and therefore, D-dimer measurement may be associated with evolution toward worse clinical picture in COVID-19 patients. [26][27][28][29][30] Notably, Tang et al also recently highlighted that the vast majority of COVID-19 patients who died during hospital stay fulfilled the criteria for diagnosing disseminated intravascular coagulation (71.6 versus 0.6% in survivors). In the present study mean D-dimer values reduced significanctly in all subjects at the end of therapy (EOT) and it was statistically significant.…”

Section: Discussionmentioning

confidence: 99%

A prospective, open label clinical study to evaluate the safety, efficacy and tolerability of azadvir herbal steam inhaler in asymptomatic, mildly symptomatic COVID-19 patients and health care workers posted to covid wards

Pottirayil¹,

Shankar

Kannoth³

et al. 2021

Int J Basic Clin Pharmacol

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Background: COVID-19 patients experience cytokine storm which cause pulmonary and extra-pulmonary complications even with currently available of standard of care. Additional antiviral and immune boosters are the need of hour to treat COVID-19 and to prevent post covid complications.Methods: In this study we enrolled 40 asymptomatic to mild COVID-19 patients to receive azadvir herbal steam inhaler along with standard of care. We evaluated the benefits of azadvir herbal steam inhaler by assessing RT-PCR conversion, clinical outcomes and improvement in immune markers (LDH, CRP, D-DIMER).Results: At the end of the study the immune markers improved significantly in study patients. In mild symptomatic cases IL-6 was 23.2 pg/ml on day 0 and 21.8 pg/ml on day 14. Reduction in IL-6 in mild symptomatic patients was statistically highly significant (p=0.0056). Mean IL-6 in asymptomatic patients was 22.3 pg/ml on day 0 and 21.1 pg/ml on day 14. Reduction in IL-6 in asymptomatic patients was statistically highly significant (p=0.0035). Mean D-dimer was showing decreasing trend from day 0 to day 14 in mild symptomatic patients. In asymptomatic patients D dimer was 0.8 µg/ml on day 0 and 0.6 µg/ml on day 14. D-dimer decreased significantly from day 0 to day 14 (p value =0.0013). Mean LDH values on day 0 in mild symptomatic patients was 319.4 U/l and 219.3 on day 14. The reduction in LDH values in mild symptomatic patients is statistically significant (p value <0.0122). In asymptomatic patients mean LDH values on day 0 was 237 U/l and 194 U/l on day 14. The reduction in LDH values in asymptomatic group was statistically significant. Mean CRP values in mild symptomatic patients on day 0 was 12.2 mg/l and 3.8 mg/l on day 14. There was significant reduction in CRP values in mild symptomatic group which was statistically significant (p value =0.0546). Mean CRP values in asymptomatic patients on day 0 was 4.9 mg/l and 2.8 mg/l on day 14. There was significant reduction in mean CRP in asymptomatic patients which was statistically significant (p value =0.0446). In the present study all 40 patients (100%) cleared the virus and became negative for RT PCR test within 6 days. None of the patients progressed to severe COVID-19 and none of the patients succumbed to the disease.Conclusions: Azadvir accelerated recovery of COVID-19 patients by RT-PCR conversion, early improvement in clinical symptoms and immune markers in this study. This study results clearly indicates that azadvir has antiviral, immune booster activity and has definitive role in the management of asymptomatic to mild COVID-19 patients along with standard of care (CTRI no. CTRI/2020/06/026181).

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“…The usefulness of several biomarkers has been suggested to assess/monitor the severity of the disease in these patients. Interestingly, in patients with hyperglycemia and COVID-19 increased D-dimer levels have been found [ 163 , 164 ]. Quin et al, reported that elevated levels of D-Dimer (OR: 1.095, 95% CI: 1.045–1.148, p <0.001) in T2D patients were associated with an increased mortality.…”

Section: Impact Of Obesity and T2d In Covid-19 Patientsmentioning

confidence: 99%

“…Most of the clinical studies found in this review compared patients with severe and non-severe symptoms, and survivors vs. non-survivors. By extracting clinical summarized data, various studies showed significant evidence of a systemic reduction in T-cell populations (lymphocytopenia) in obese/T2D patients as COVID-19 progressed [ 134 , 155 , 156 , 158 , 162 , 163 , 164 , 170 ]. Importantly, patients hospitalized with underlying conditions presented worse lymphocytopenia than those who did not report comorbidities [ 178 , 185 , 186 , 187 , 189 ].…”

Section: Impact Of Obesity and T2d In Covid-19 Patientsmentioning

confidence: 99%

Immune Response to SARS-CoV-2 Infection in Obesity and T2D: Literature Review

et al. 2021

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In December 2019, a novel coronavirus known as SARS-CoV-2 was first detected in Wuhan, China, causing outbreaks of the coronavirus disease COVID-19 that has now spread globally. For this reason, The World Health Organization (WHO) declared COVID-19 a public health emergency in March 2020. People living with pre-existing conditions such as obesity, cardiovascular diseases, type 2 diabetes (T2D), and chronic kidney and lung diseases, are prone to develop severe forms of disease with fatal outcomes. Metabolic diseases such as obesity and T2D alter the balance of innate and adaptive responses. Both diseases share common features characterized by augmented adiposity associated with a chronic systemic low-grade inflammation, senescence, immunoglobulin glycation, and abnormalities in the number and function of adaptive immune cells. In obese and T2D patients infected by SARS-CoV-2, where immune cells are already hampered, this response appears to be stronger. In this review, we describe the abnormalities of the immune system, and summarize clinical findings of COVID-19 patients with pre-existing conditions such as obesity and T2D as this group is at greater risk of suffering severe and fatal clinical outcomes.

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Relation of D-dimer levels of COVID-19 patients with diabetes mellitus

Cited by 47 publications

References 12 publications

D-dimer level is a useful predictor for mortality in patients with COVID-19: Analysis of 483 cases

D-dimer level is a useful predictor for mortality in patients with COVID-19: Analysis of 483 cases

A prospective, open label clinical study to evaluate the safety, efficacy and tolerability of azadvir herbal steam inhaler in asymptomatic, mildly symptomatic COVID-19 patients and health care workers posted to covid wards

Immune Response to SARS-CoV-2 Infection in Obesity and T2D: Literature Review

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