Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 642 – 648
ISSN: 2791-0814 (online) 2791-0807 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr090
ISSN: 2791-0814 (online) 2791-0807 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr090
D-dimer levels and lymphocyte counts as prognostic and predictive factors in children with COVID 19
Swathi Chayaprakash\(^{1,*}\), Shylaja C G\(^{2}\), Sanvithi Anjanappa\(^{3}\) and Kavya VN\(^{4}\)
\(^{1}\) Final Year Postgraduate, Department of Paediatrics, Kempegowda Institute of Medical Sciences, Bangalore, India.
\(^2\) Assistant Professor, Department of Paediatrics, Kempegowda Institute of Medical Sciences, Bangalore, India.
\(^3\) Intern, Kempegowda Institute of Medical Sciences, Bangalore, India.
\(^4\) Final Year Postgraduate, Department of Paediatrics, Kempegowda Institute of Medical Sciences, Bangalore, India.
Correspondence should be addressed to Swathi Chayaprakash at swathichayaprakash@gmail.com
Copyright © 2023 Swathi Chayaprakash, Shylaja C G, Sanvithi Anjanappa and Kavya VN. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: January 12, 2023 – Accepted: May 20, 2023 – Published: May 24, 2023
Abstract
Background: Coronavirus Disease 2019 (COVID-19) is characterized by high fever, sudden developing respiratory distress. The Purpose of this study is to identify the association of D-dimer levels and lymphocyte counts with poor prognosis and to predict the clinical course in patients with COVID-19.
Methods: A Total of 85 hospitalized children diagnosed with COVID 19 were included in the study. According to AIIMS guidelines, they were divided into two groups, one with severe disease (N=23) and other with non-severe disease which included mild to moderate cases (n=62), distinctive performance analysis of these values were performed and the cut off values were determined.
Results: A total of 85 hospitalized patients with COVID-19 were included in the final analysis. The mean age was 10 \(\pm\) 5 years and 45 (52.9%) were males. Lymphocyte count was found as statistically significantly low (p <0.001) while D-dimer level was statistically significantly higher in the group with severe disease (p <0.001). As for the effectiveness of lymphocyte count in distinguishing severe and non-severe patients with COVID-19 when cut-off score 1500/mm3 was taken, sensitivity was 30% and specificity was 77% and that of D-dimer when cut-off score 2 mg/L was taken, sensitivity was 22% and specificity was 50%. D-dimer level was found to have a significant discrimination power (AUC = 0.879, p < 0.0001,95% CI).
Conclusions: The lymphocyte value of \(\leq 1500/mm3\) and D-dimer value of \(\geq 2mg/L\) can be used in the early determination of patients with poor prognosis in COVID-19. Using these cut-off values for D-dimer and lymphocyte count will help predict prognosis and make rapid treatment decisions in patients with COVID-19.
Methods: A Total of 85 hospitalized children diagnosed with COVID 19 were included in the study. According to AIIMS guidelines, they were divided into two groups, one with severe disease (N=23) and other with non-severe disease which included mild to moderate cases (n=62), distinctive performance analysis of these values were performed and the cut off values were determined.
Results: A total of 85 hospitalized patients with COVID-19 were included in the final analysis. The mean age was 10 \(\pm\) 5 years and 45 (52.9%) were males. Lymphocyte count was found as statistically significantly low (p <0.001) while D-dimer level was statistically significantly higher in the group with severe disease (p <0.001). As for the effectiveness of lymphocyte count in distinguishing severe and non-severe patients with COVID-19 when cut-off score 1500/mm3 was taken, sensitivity was 30% and specificity was 77% and that of D-dimer when cut-off score 2 mg/L was taken, sensitivity was 22% and specificity was 50%. D-dimer level was found to have a significant discrimination power (AUC = 0.879, p < 0.0001,95% CI).
Conclusions: The lymphocyte value of \(\leq 1500/mm3\) and D-dimer value of \(\geq 2mg/L\) can be used in the early determination of patients with poor prognosis in COVID-19. Using these cut-off values for D-dimer and lymphocyte count will help predict prognosis and make rapid treatment decisions in patients with COVID-19.
Keywords:
Covid-19; D-dimer; Lymphocyte count.