JOURNAL COVER PAGE
 
 
 
 
VOLUME 9,ISSUE 3
July - September 2020
 
Abstract

Correlation of Coagulation Abnormalities and Severity of Disease by Computed Tomography in Indian COVID-19 patients

Bhandari S1, Rankawat G2*, Bagarhatta M3, Singh A4, Agrawal A5, Kumar A6

1. Senior professor, Department of General medicine, SMS Medical college and attached group of Hospital, Jaipur, Rajasthan, India. 2. Resident/Fellow student, Department of General Medicine, SMS medical college, Jaipur, Rajasthan, India. 3. Senior professor, Department of Radiodiagnosis, SMS Medical college and attached group of Hospital, Jaipur, Rajasthan, India. 4. Senior specialist, Department of General medicine, SMS Medical college and attached group of Hospital, Jaipur, Rajasthan, India 5. Senior professor, Department of General medicine, SMS Medical college and attached group of Hospital, Jaipur, Rajasthan, India. 6. Senior Demonstrator, Department of Pathology, SMS Medical college and attached group of Hospital, Jaipur, Rajasthan, India.

ABSTRACT

Background: The present study was undertaken to investigate and quantify the abnormal coagulable state in COVID-19 patients and to correlate it with the severity of COVID-19 infection as determined by high-resolution computed tomography (HRCT) of the chest. Materials and methods: In an attempt to provide extensive information pertaining to blood coagulation and radiological characteristics of COVID-19, the present study was undertaken in120 hospitalized patients with SARS CoV-2 infection confirmed positive by RT-PCR at SMS Hospital, Jaipur, India. For all patients, coagulation profile was evaluated in form of fibrin degradation products (FDP) and D-dimer, Theses values were then correlated with HRCT chest findings. Results: Among the confirmed cases, most of patients were young adults, in the fifth and sixth decade of age group with mean age of 50.40 years. There was a male preponderance (59% male and 41% female). Out of total analyzed patients,59 patients (49.16%) were symptomatic and55% patients had some underlying co-morbid disease. Fifty-one patients (42.5%) had raised FDP with mean value 17.9μg/mL while sixty-six patients (55%) had elevated D-dimer level with mean value 3.3μg/mL. We found 60.83% patients had CT findings classically described with COVID-19 infection. In 91.2% of those with normal FDP levels and 94.5% of those with D-dimer within normal levels, the CT severity score was found to be <10/25. CT severity score was found to be >10/25 in 78% and 68% patients respectively who had FDP and D-Dimer level more than four times of upper normal limits (UNL). Pearson correlation coefficient for FDP and CT severity score were found r = +0.6494 with p-value<0.001 while for D-dimer and CT severity score r = +0.7143 with p-vale<0.001.Classic for COVID images were found to be in 100% and 94% patients respectively who had extremely elevated FDP and D-dimer level more than four times of UNL. Conclusion: HRCT chest in COVID-19 patients can detect severity of pulmonary involvement, thus had a major prognostic importance. Blood levels of FDP and D-dimer directly correlated with CT severity score and Classic CT images for COVID-19.

Keywords: COVID-19, Computed tomography chest, D-dimer, Hypercoagulable state


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