Abstract Number: PB0235
Meeting: ISTH 2021 Congress
Background: Since the emergence of COVID-19 pandemic, a growing evidence showed that this disease is associated with disturbances in hemostatic components, defining a COVID-19 associated coagulopathy. This is reflected in the lab tests with an increase in D-dimer and Fibrinogen, which correlate with severity and outcomes of disease.
Aims: To assess the association between elevation of fibrinogen and d-dimer with worsening of COVID-19 disease, as well as the prognostic value of these two markers.
Methods: We conducted a prospective single-center study, including patients with confirmed COVID-19 consecutively admitted over a period of 05 months. Fibrinogen and D-Dimer were tested and the correlation with clinical stages, and prognosis were studied.
Results: 131 patients with confirmed COVID-19 (Mean age 47 years; 13% with severe and critical cases; 73.3% male) were included in this study. The most frequent comorbidities were : high blood pressure 27.9% and diabetes 23.5%.
Levels of D-Dimer and Fibrinogen increased considerably in severe and critical cases compared to mild, moderate and asymptomatic cases. For Fibrinogen: 4.81 gr/L [CI 4.40 – 5.22] Vs 3.53 gr/L [CI 3.28 – 3.77] (p 0.026). For D-Dimer 1308 µg/ml [CI 703 – 1913] Vs 820 µg/ml [CI 338 – 1302] (p 0.0001).
The results from ROC analyses for predicting severe and critical cases showed that the AUC of Fibrinogen the AUC was at 0.75 also with two cut-off values : 4.46 gr/L (Se : 67.9% , Sp : 78.2% ) and 5.49 gr/L (Se : 34% , Sp : 97.4% ). For D-Dimer AUC was 0.7, with two cut-off values : 750 µg/ml (Se : 56.8% , Sp : 78.72% ) and 1790 µg/ml (Se : 24.32% , Sp : 95.7% ).
|Association between increased levels of Fibrinogen , D-Dimer and COVID-19 severity|
|Severe and critical cases||Asymptomatic , mild and moderate cases|
|Fibrinogen mean (gr/L)||4.81 gr/L [CI 4.40 – 5.22]||3.53 gr/L [CI 3.28 – 3.77]|
|Fibrinogen Cut-off values||AUC = 0.756
1st Cut-off value : 4.46 gr/L (Se 67.9% Sp 78.2% VPP 31.8% VPN 94.2%).
2nd cut-off value : 5.49 gr/L (Se 34% Sp 97.4% VPP 66.4% VPN 90.8%).
|D-Dimer mean (µg/ml)||1308 µg/ml [CI 95%: 703 – 1913]||820 µg/ml [CI 95% : 338 – 1302]|
|D-Dimer Cut-off values||AUC = 0.700
1st Cut-off value : 750 µg/ml (Se 56.8% Sp 78.7% VPP 28.5% VPN 92.4%).
2nd cut-off value : 1790 µg/ml (Se 24.32% Sp 95.74% VPP 46.1% VPN 89.4%).
Conclusions: Fibrinogen and D-dimers in patients with COVID-19 should be used as prognostic markers for warning of severe cases.
To cite this abstract in AMA style:El Horri M, Touati SNE, Khachaa I, Chikh Khelifa A, Berrah A, Benmahdi L, Belakehal SE. Fibrinogen and D-dimer Are Significantly Associated with Severity of COVID-19 Disease [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/fibrinogen-and-d-dimer-are-significantly-associated-with-severity-of-covid-19-disease/. Accessed December 5, 2021.
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