Comparison of D-Dimer Level on Mild, Moderate and Severe COVID-19 at Immanuel Hospital Bandung City October 1 ^st - December 31 ^st, 2020

Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In COVID-19 there is a process of thrombosis and coagulopathy, which are systemic inflammation and endothelial disorders resulting in hypercoagulability. D-dimer is a laboratory test that can determine coagulation activation (hypercoagulability) and fibrinolysis. D-dimer can be used as a guide of anticoagulant and thrombolytic therapy and prognostic parameter in COVID-19 patients, where its value runs parallel to the severity of the disease and is associated with increased mortality.

Materials and methods: The whole sampling was taken from 59 medical records of inpatients confirmed with COVID-19 through the RT-PCR examination at Immanuel Hospital, Bandung City for the period of October 1 ^st - December 31 ^st, 2020. The value of d-dimer was taken from whole blood, tested with sandwich ELISA method with cut-off value (normal value) < 0.5μg/ml. COVID-19 patient classification was based on the COVID-19 guideline from Indonesian Ministry of Health. The research method was observational analytical with cross-sectional design. Statistical test used was Kruskal-Wallis test with Mann-Whitney advanced test (α = 0.05).

Results: The mean d-dimer value in patients with mild, moderate, and severe COVID-19 was 0.3034 µg/mL; 0.5138 µg/mL; and 1.1751 µg/mL. The results of Kruskal-Wallis test showed a very significant difference in mean d-dimer values in mild, moderate, and severe COVID-19 patients. Mann-Whitney test showed that there was a very significant difference in the mean d-dimer value between mild and severe COVID-19 patients, also between moderate and severe COVID-19 patients with a value of p = 0.000 (p <0.01). But there was no difference in the mean d-dimer value between mild and moderate COVID-19 patients, p = 0.454 (p> 0.05).

Conclusion: There is a very significant difference in d-dimer values between mild, moderate and severe COVID-19 patients. The d-dimer value increases with the severity of COVID-19.

Keywords: COVID-19, mild COVID-19, moderate COVID-19, severe COVID-19, d-dimer