D-Dimer, Activated Partial Thromboplastin Time, and Prothrombin Time Comparison in Different Severity Levels of COVID-۱۹ in Pregnancy: A Single Center Study

Background & Objective: Uncertainties exist about the diagnostic and prognostic role of hemocytometry values in patients with COVID-۱۹ especially in pregnancy. This study aims to investigate hemostatic changes in pregnant woman with coronavirus disease (COVID-۱۹) and their relationship to disease severity.Materials & Methods: This research is an analytic observational study with case control design. Subject was gathered from Hasan Sadikin General Hospital Bandung, Indonesia patients' medical records from June ۲۰۲۱ – March ۲۰۲۲. Inclusion criteria for this study are all pregnant COVID-۱۹ patients with prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer examination. The exclusion of this study, all pregnant COVID-۱۹ patients without required examination. PT, aPTT, and D-dimer were measured by Stago kits on a Stago automated coagulation analyzer (STA Compact Max®). Data was then analyzed by Kruskal Wallis with IBM SPSS Statistic ۲۶th with α=۰.۰۵.Results: Statistical analysis shows there’s correlation between different severity levels with D-Dimer. This study shows the mean of D-Dimer of each severity levels; asymptomatic ۴.۸۵ mg/L, mild ۲.۸۶ mg/L, moderate ۵.۴۷ mg/L and severe ۱۴.۵۱ mg/L (p <۰.۰۰۰). Changes seen after mild group which increase to ۵.۴۷ mg/dL in moderate COVID-۱۹ and furthermore increase in severe become ۱۴.۵۱ mg/L. No changes in PT and aPTT were found.Conclusion: In conclusion, our findings demonstrate that coagulopathy is associated with the severity of COVID-۱۹ illness. D-dimer is an important parameter for evaluating the COVID-۱۹ severity in pregnancy. This further could serve as a diagnostic category to differ the severity of COVID-۱۹ in pregnancy.

Keywords:

COVID-۱۹ , Pregnancy , D-Dimer , Activated Partial Thromboplastin Time , Prothrombin Time , Severity