ASSOCIATION BETWEEN ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) INCIDENCE AND INCREASED D-DIMER IN COVID-19 PATIENTS AT BETHESDA HOSPITAL YOGYAKARTA

Authors

  • Frans Iqlessias Hutagaol Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia
  • Wiwiek Probowati Internal Medicine Department, Bethesda Hospital, Yogyakarta, Indonesia
  • Widya Christine Manus Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia

DOI:

https://doi.org/10.21460/bikdw.v9i1.930

Keywords:

ARDS, coagulopathy, COVID-19, D-dimer levels

Abstract

Background: Acute Respiratory Distress Syndrome (ARDS) is one of the most common complications of COVID-19 infection and is closely related with patient mortality. Increased D-dimer levels are considered one of the most consistent clinical indicators of coagulopathy. Theoretically, this event is based on the emergence of a cytokine storm triggering lung tissue damage, pulmonary microvascular endothelial damage and alveolar edema, leading to hypoxia in the body. Objective: To determine the association between ARDS incidence and the increase in D-dimer levels in COVID-19 patients at Bethesda Hospital Yogyakarta. Method: This research was conducted in retrospective cohort design. The data utilized in this study came from the medical records of male and female COVID-19 patients between 19 and 60 years old, who were diagnosed with ARDS by doctors at Bethesda Yogyakarta Hospital. The medical records were collected between June 1, 2021, and September 30, 2021. The data analysis included univariate (descriptive statistics) and bivariate (Chi-Square, Mann-Whitney, Spearman Rank) analyses. Result: There was a significant relationship between COVID-19 ARDS patients and the increased levels of D-dimer in patients undergoing hospitalization at Bethesda Hospital Yogyakarta (p<0,001, OR=4,589, 95%CI=2,104-10,007). Additionally, there was a significant difference in D-dimer levels between ARDS and non-ARDS patients. The severity of ARDS, duration of hospitalization, gender, and age did not have a significant association with the increase in D-dimer levels (p>0,05). Conclusion: There was a significant relationship between the incidence of ARDS and elevation of D-dimer levels in COVID-19 patients at Bethesda Hospital Yogyakarta.

References

Harapan H, Itoh N, Yufika A, Winardi W, Keam S, Te H Megawati, D Hayati, Z Wagner A L., & Mudatsir, M. Coronavirus disease 2019 (COVID-19): A literature review. Journal of Infection and Public Health, 13(5), 2020; 667–673. https://doi.org/10.1016/j.jiph.2020.03.019

Hasan S, Capstick T, Ahmed R, Kow C. S, Mazhar F, Merchant H. a, Zaidi, S. T. R, Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use a systematic review and meta-analysis. Expert Review of Respiratory Medicine, 2020; 14(11), 1149–1163. https://doi.org/10.1080/17476348.2020.1804365

Arie Zainul Fatoni, R. R, ARDS_Indo. Acute Respiratory Distress Syndrome (ARDS) in COVID-19 Pneumonia Acute, 2021;2(1), 11–24.

Gibson P G, Qin L, Puah S H. COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Medical Journal of Australia, 2020; 213(2), 54-56.e1. https://doi.org/10.5694/mja2.50674

William H A, Hardigaloeh A T, Supit A I. Coagulopathy in Coronavirus Disease -2019 (COVID-19): A literature review. Essence of Medical Sciences, 2020; 11(3), 749–756. https://doi.org/10.15562/ism.v11i3.766

Sehgal T, Gupta N, Kohli S, Khurana A, Dass J, Diwan S, A J M Khan, M Aggarwal, M Subramanian, A. A prospective study of specialized coagulation parameters in admitted COVID-19 patients and their correlation with acute respiratory distress syndrome and outcome. Cureus, 2020;13(8). https://doi.org/10.7759/cureus.17463

Riandini H M, Syaran F, Bihar S, Eyanoer P C. Associations Between Severity Of Symptoms, D-Dimer and Incidence of ARDS In COVID-19. Respiratory Science, 2022; 2(3), 143–147. https://doi.org/10.36497/respirsci.v2i3.40

Autschbach T, Hatam N, Durak K, Grottke O, Dreher M, Nubbemeyer K, Rossaint R, Marx G, Marx, N, Spillner J, Zayat R, Kalverkamp S, Kerste A. Outcomes of extracorporeal membrane oxygenation for acute respiratory distress syndrome in covid-19 patients: A propensity-matched analysis. Journal of Clinical Medicine, 2021; 10(12). https://doi.org/10.3390/jcm10122547

Walandow K J, Mar?? S R, Engka J N A, Correspondence P. Comparison of D-dimer Levels in Moderate and Severe COVID-19 Patients. EBiomedik, 2022;10(1), 29–34.

Mubarak R, Esa T, Widaningsih Y, Bahrun, U. D-Dimer Analysis in COVID-19 Patients. In Indonesian Journal of Clinical Pathology and Medical Laboratory 2021; (Vol. 28, Issue 1, pp. 5–9). https://doi.org/10.24293/ijcpml.v28i1.1812

Ortega-Paz L, Capodanno D, Montalescot G, Angiolillo D J. Coronavirus disease 2019–associated thrombosis and coagulopathy: Review of the pathophysiological characteristics and implications for antithrombotic management. Journal of the American Heart Association, 2021; 10(3), 1–24. https://doi.org/10.1161/JAHA.120.019650

Robba C, Camporota L, Citerio G. Acute respiratory distress syndrome complicating traumatic brain injury. Can opposite strategies converge? Intensive Care Medicine, 2023; 49(5), 583–586. https://doi.org/10.1007/s00134-023-07043-6

Estenssoro E, Loudet C I, Dubin A. Clinical Characteristics and Outcomes of Invasively Ventilated Patients With COVID-19 in Argentina (SATICOVID): A Prospective, Multicentre Cohort Study. Lancet Respir Med 2021; 9:989-98

Putra, M. K., Utarian, A., Semedi, B. P., Waloejo, C. S., & Hardiono. (2021). The Use of Ventilatory Ratio and Alveolar Dead Space Fraction as Predictors of Mortality in COVID-19 Patients with Acute Respiratory Distress Syndrome. Journal of Perioperative Anesthesia, 9(1), 10–17. https://doi.org/ 10.15851/jap.v9n1.2274

Ngakan Putu Parsama Putra, Aditya Sri Listyoko, Anthony Christanto. PaO2, SaO2, and PaO2/FiO2 Ratio as Predictors of Severity of Inpatient COVID-19 Patients. Journal Of The Indonesian Medical Association, 2021;70(12), 253–259. https://doi.org/10.47830/jinma-vol.70.12-2020-326

Wang X, Zhu L, Liu J, Chen K, Liu X, Liu Z, Xin C, Chen Y, Lu J, Yi C. Prognostic Factors in COVID-19 Pneumonia with Severe Acute Respiratory Distress Syndrome: An Observational Study. Yangtze Medicine, 2021;05(04), 249–265. https://doi.org/ 10.4236/ym.2021.54024

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 2020; 395(10229), 1054–1062. https://doi.org/10.1016/S0140-6736(20)30566-3

Yao Q, Wang P, Wang X, Qie G, Meng M, Tong X, Bai X, Ding M, Liu W, Liu K, Zhou Y. A retrospective study of risk factors for severe acute respiratory syndrome coronavirus 2 infections in hospitalized adult patients. Polish Archives of Internal Medicine, 2020;130(5), 390–399. https://doi.org/10.20452/ pamw.15312

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

Gabriella M, Rogliani P, Calzetta L, Cazzola M. Pharmacological management of COVID-19 patients with ARDS ( CARDS ): A narrative review. January ; 2020

Aslan A, Aslan C, Zolbanin N M, Jafari R . Acute respiratory distress syndrome in COVID-19: possible mechanisms and therapeutic management. Pneumonia, 2021;13(1). https://doi.org/10.1186/s41479-021-00092-9

Liu Y C, Kuo R L, Shih S R. COVID-19: The first documented coronavirus pandemic in history. Biomedical Journal, 2020;43(4), 328–333. https://doi.org/10.1016/j.bj.2020.04.007

Rachmawati M R, Amiarno Y, Restuti Y, Guslianti W, Adriyanti L, Fajriah N. Age and Gender as The Risk Factors for Mortality Rate in COVID-19 Patients. Bali Medical Journal, 2022;11(3), 2017–2021. https://doi.org/10.15562/bmj.v11i3.3446

Karki D, Gurung R, Nepali P, Kaphle H P, Subedi B, Adhikari S. Raised D-dimer among Admitted COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study. Journal of the Nepal Medical Association, 2022;60(251), 596-599. https://doi.org/10.31729/jnma.7579

Gujski M, Jankowski M, Rabczenko D, Gory?ski P, Juszczyk G. The Prevalence of Acute Respiratory Distress Syndrome (ARDS) and Outcomes in Hospitalized Patients with COVID-19 - A Study Based on Data from the Polish National Hospital Register. Viruses, 2022; 14(1). https://doi.org/10.3390/ v14010076

Downloads

Published

2024-08-30

Issue

Vol. 9 No. 1 (2024): BERKALA ILMIAH KEDOKTERAN DUTA WACANA

Section

Research

Citation Check

License

Copyright (c) 2024 Frans Iqlessias Hutagaol, Wiwiek Probowati, Widya Christine Manus

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors who publish in Berkala Ilmiah Kedokteran Duta Wacana agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Attribution-ShareAlike 4.0 International (CC BY-SA 4.0) License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

This work is licensed under CC BY-SA 4.0