Authors :
Jilientasia Godrace Lilihataa; Bambang Pujo Semedia; Arie Utariania; Nila Kurniasarib; Etty Hary Kusumastutib; Priangga Adi Wiratamab; Isnin Anang Marhanac; Alfian Nur Rosyidc; Dwi Wahyuc; Ummi Maimunahd; Achmad Lefie; Edy Suyantof; Adhitri Anggoroc; Supriadid; Lalu Galih Pratamae; Gilang Muhammadc; Stephanie Natasha Djuandab; Komang Rusgi Yandic
Volume/Issue :
Volume 7 - 2022, Issue 1 - January
Google Scholar :
http://bitly.ws/gu88
Scribd :
https://bit.ly/33OpL1n
DOI :
https://doi.org/10.5281/zenodo.5910705
Abstract :
COVID-19 is a global concern
that emerged and became a pandemic at March 2020. It is
related to dysregulation of immune system causing
excessive immune response known as cytokine storm.
Other than that there is hypercoagulation that could
progress to thrombosis and embolism in various vital
organs. Pulmonary embolism is one of the dire
consequences of hypercoagulation. CTPA and V/Q scan
are the gold standards in pulmonary embolism diagnosis.
However in developing countries like Indonesia these
facilities are often absent. Thus a simple blood test like Ddimer could aid the detection of pulmonary thrombosis in
COVID-19.
Materials and methods: Subjects were 34 patients who
died because of COVID-19 in COVID-19 isolation ICU at
Dr. Soetomo General Hospital, Surabaya, Indonesia.
Clinical information, radiologic and laboratory results
were retrieved from medical record files.
Histopathological examination was done by routine
hematoxylin and eosin staining and CD61
immunohistochemistry staining of lung tissues. Tissues
were obtained by core biopsy and examined under 100x
and 400x magnification.
Results: All samples examined had positive CD61 results
for platelet microthrombi. Focal microthrombi were
found in 61.8% of samples while the rest 38.2% had
diffuse microthrombi. There was significant difference in
D-dimer levels between patiens who had focal and diffuse
microthrombi (p value 0.035). Analysis using ROC curve
showed D-dimer level cut-off of 3055 ng/ml had 61.5%
sensitivity and 71.4% specificity for the findings of diffuse
pulmonary microthrombi.
Conclusion: D-dimer values above 3055 ng/ml indicated
the presence of diffuse microthrombi in the lungs. Ddimer can be used to aid the diagnosis of diffuse lung
microthrombi in COVID-19 patients
Keywords :
COVID-19, pulmonary embolism, microthrombi, D-dimer, CD61
COVID-19 is a global concern
that emerged and became a pandemic at March 2020. It is
related to dysregulation of immune system causing
excessive immune response known as cytokine storm.
Other than that there is hypercoagulation that could
progress to thrombosis and embolism in various vital
organs. Pulmonary embolism is one of the dire
consequences of hypercoagulation. CTPA and V/Q scan
are the gold standards in pulmonary embolism diagnosis.
However in developing countries like Indonesia these
facilities are often absent. Thus a simple blood test like Ddimer could aid the detection of pulmonary thrombosis in
COVID-19.
Materials and methods: Subjects were 34 patients who
died because of COVID-19 in COVID-19 isolation ICU at
Dr. Soetomo General Hospital, Surabaya, Indonesia.
Clinical information, radiologic and laboratory results
were retrieved from medical record files.
Histopathological examination was done by routine
hematoxylin and eosin staining and CD61
immunohistochemistry staining of lung tissues. Tissues
were obtained by core biopsy and examined under 100x
and 400x magnification.
Results: All samples examined had positive CD61 results
for platelet microthrombi. Focal microthrombi were
found in 61.8% of samples while the rest 38.2% had
diffuse microthrombi. There was significant difference in
D-dimer levels between patiens who had focal and diffuse
microthrombi (p value 0.035). Analysis using ROC curve
showed D-dimer level cut-off of 3055 ng/ml had 61.5%
sensitivity and 71.4% specificity for the findings of diffuse
pulmonary microthrombi.
Conclusion: D-dimer values above 3055 ng/ml indicated
the presence of diffuse microthrombi in the lungs. Ddimer can be used to aid the diagnosis of diffuse lung
microthrombi in COVID-19 patients
Keywords :
COVID-19, pulmonary embolism, microthrombi, D-dimer, CD61
