The severe acute respiratory syndrome corona virus 2 (SARS-COVID-19) was found in December 2019. From then onwards it has created havoc in the entire nation. More than 2 million people have been infected in the country and this toll is increasing every day. Deaths have become more evident in the recent time which has created a topic of concern. Since the severity of cases has increased significantly it is important to determine the condition of patient beforehand so that adequate steps can be taken. D-Dimer test in one such process through which we can determine the severity of COVID infected patient.
What is D-Dimer Test?
D-dimer is a protein which is made of small fragments when the blood clot dissolves in the body. Blood clotting is an important aspect in regards with COVID-19 as it involves loosing of blood when there is injury. The body dissolves the clot once injury is on the healing side. There could be a blood clotting disorder in which clots can form when there is no injury as well. This condition can be very life threatening and severe. D-dimer test helps to determine if there is any clotting formation in the body.
How is D-Dimer Test Related to COVID-19?
Dr. Mayur Nigalye, Head of Haematology Department in Metropolis Healthcare Lab explains how D-dimer test is linked to COVID-19. According to him this test can determine the severity of the patient suffering through corona virus. There are abnormal coagulation functions present including elevated D-dimer in COVID patients with deceased COVID-19. If the value of D-dimer test is more than 1μg/ml then it is more likely that the patient is severe and the mortality rate could be higher for that person.
However it is still in process and cannot be said clearly about the odds related to severity of COVID-19 in patients with D-Dimer. The coagulation function parameters are compared which do not have corona virus that D-dimer levels are considerably higher and severe in COVID-19 patients.
What Is D-dimer Test Used For?
It is used to find out if there is any blood clotting disorder. This disorder may also result in some serious conditions hence is it important to determine these conditions-
1. Deep Vein Thrombosis (DVT): These blood clots are found deep inside the vein, especially in the lower legs. It can also happen in other parts of body as well.
2. Pulmonary Embolism (PE): This is the condition of blockage of artery or vein in the lungs. It happens mostly when blood clot breaks loose and moves to another part of the body through lungs. This causes DVTs as well.
3. Disseminated Intravascular Coagulation (DIC): It causes many clots throughout the body which can cause serious damage to health. It can cause organ damage and traumatic injuries and many other health complications. This can even lead to cancer.
4. Stroke: It can cause blockage in the supply of blood to the brain.
Symptoms of DVT and PE for D-Dimer Test
These symptoms show that you may be suffering from blood clotting disorder which can be either deep vein thrombosis or pulmonary embolism.
For DVT symptoms are-
- Leg Pain
- Tenderness in Legs
- Swelling of Legs
- Redness or streaks on the legs
For PE symptoms are-
- Difficulty in breathing
- Chest Pain
- Rapid Breathing
D-Dimer Relation to Heart Diseases
Corona affects the plasma, but high levels of d-dimer in the plasma can also be an indicator of activated coagulation and fibrinolysis which predicts the pulmonary embolism. Pulmonary embolism also leads to in coronary heath disease, stroke and peripheral artery diseases. High availability of d-dimer in the blood causes inflammation in the arterial wall. CRP levels are correlated with fibrinogen, IL-6, d-dimer and t-PA levels. High level of d-dimer in blood can also determine systolic blood pressure, cholesterol levels, triglyceride level, body mass index and smoking status too.
Generation of D-Dimer
During the coagulation process our lever produces several proteins which include fibrinogen. A single molecule of fibrinogen is symmetrical dimmer. It is made up of three pairs which constitute of three different polypeptide chains namely a, b and g. Each chain is comprised of single fibrinogen molecule and is bonded together by disulfide bonds. When the injury occurs, the fibrinolytic system activates to limit the size of the clot.
It releases plasminogen activator from the vascular endothelial cells to allow the molecule to bind to the fibrin surface of plasmin. This fibrin-bound plasmin is responsible for degradation of fibrin network into several soluble fragments that include D-Dimer in them. It is found in (DD)E complex.
D-dimer in the blood plasma has a half life of 8 hours until kidney clears it. It is used as clinical biomarker to identify thrombotic activities which also determine conditions like pulmonary embolism, deep vein thrombosis, disseminated intravascular coagulation and now COVID-19 as well.
D-dimer test is useful to determine the condition of patient suffering from COVID-19. It helps to know the severity of the patient. If the value of dimer is evident or more then it is more likely that the patient is in severe condition. It also helps to know the risk of coronary heart disorder and pulmonary embolism which is a cause of many serious conditions. D-dimer is verified by the intensity of blood clotting in the body. It also helps to find the blood disorders if there are any. It is a very useful method which can help identify many serious condition and severity of COVID patients.
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