PROGNOSTIC ROLE OF D-DIMER AND COAGULATION ABNORMALITIES IN PREDICTING LONG-TERM COMPLICATIONS IN TYPE 2 DIABETES MELLITUS (T2DM) POST-COVID SURVIVORS: A RETROSPECTIVE OBSERVATIONAL STUDY
Main Article Content
Keywords
T2DM, COVID-19, D-dimer, Coagulation abnormalities, Fibrinogen, Retrospective study, Prognostic markers
Abstract
Background:
COVID-19 has been shown to significantly worsen metabolic and coagulation pathways, particularly in individuals with Type 2 Diabetes Mellitus (T2DM). Elevated D-dimer and coagulation abnormalities may serve as prognostic indicators for long-term complications after recovery.
AimTo evaluate the prognostic significance of D-dimer and associated coagulation abnormalities in predicting early post-COVID complications among T2DM survivors.
Methods:
A retrospective observational study was conducted among 65 T2DM patients who recovered from SARS-CoV-2 infection. Clinical, biochemical and coagulation parameters including D-dimer, fibrinogen, platelet count, IL-6/CRP, and HbA1c were analyzed at baseline (COVID recovery) and at 3-month follow-up. Demographic data and comorbidity profiles were recorded.
Results:
A statistically significant association was observed between elevated D-dimer levels (> 0.5 mg/L FEU) at recovery and the development of early complications such as worsened glycemic control, elevated inflammatory markers, increased fibrinogen, and early microvascular changes. Patients with higher D-dimer levels also showed a higher frequency of hypertension exacerbation, neuropathic symptoms, and early renal dysfunction (rise in UACR) at follow-up.
Conclusion:
D-dimer is a useful early prognostic marker in predicting short-term complications in T2DM post-COVID survivors. Screening for coagulation abnormalities may significantly aid in early risk stratification and targeted management.
References
2. Zhu B et al. Coagulation abnormalities in COVID-19: D-dimer and fibrinogen. Thromb Res. 2022.
3. Chen X et al. Post-COVID inflammatory and metabolic complications in diabetics. J Clin Endocrinol Metab. 2023.
4. Gupta A et al. Hypercoagulability after SARS-CoV-2 in diabetics. J Thromb Haemost. 2021.
5. Yuen J et al. IL-6 and coagulopathy in COVID. Lancet Diabetes Endocrinol. 2022.
6. Yuen J, Ong S, Wong TY. IL-6 mediated coagulation in post-COVID syndrome among diabetics. Lancet Diabetes Endocrinol. 2022;10(4):265–73.
7. Tang N, Bai H, Chen X, Gong J, Li D. Anticoagulant treatment is associated with decreased mortality in severe COVID-19 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094–9.
8. Wiersinga WJ, Rhodes A, Cheng AC. Pathophysiology, transmission, diagnosis, and treatment of COVID-19. JAMA. 2020;324(8):782–93.
9. Sahin TK, Esen F, Ozkan S. Persistent hypercoagulation in post-COVID survivors with diabetes: 3-month outcomes. Clin Appl Thromb Hemost. 2022;28:1–8.
10. Sahu A, Patel S, Agrawal V. Impact of SARS-CoV-2 on glycemic control in Type 2 diabetes: A retrospective Indian cohort. Int J Diabetes Dev Ctries. 2023;43:230–7.
11. Fogarty H, Townsend L, Ni Cheallaigh C. Continued endothelial activation and hypercoagulability after COVID-19. Br J Haematol. 2021;192(3):571–6.
12. Wang Z, Zhou Q, Wang C. Long-term consequences of COVID-19 in T2DM patients: A systematic review. Diabetes Res Clin Pract. 2022;189:109–18.
13. Sardu C, Gargiulo G, Esposito G. Contribution of hyperglycemia to COVID-19 mortality and morbidity. Crit Care. 2020;24(1):1–4.
14. Varga Z, Flammer AJ, Steiger P. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417–8.
15. Marfella R, Paolisso P, Sardu C. Glycemic worsening and inflammation after COVID-19 in diabetics: A longitudinal study. Diabetes Care. 2022;45(3):683–91.
16. Xie Y, Xu E, Al-Aly Z. Risks of post-acute sequelae in people with diabetes following COVID-19 infection. Nat Med. 2023;29:1026–34.
17. Zuo Y, Estes SK, Ali RA. Prothrombotic autoantibodies in COVID-19. Sci Transl Med. 2020;12(570):eabd3876.
18. Kim JE, Lee SY, Park JH. Predictive value of D-dimer in post-COVID microvascular complications. Front Endocrinol. 2023;14:1120–8.
19. Lippi G, Favaloro EJ. D-dimer and COVID-19 severity: An updated meta-analysis. Clin Chem Lab Med. 2021;59(2):201–5.
20. Paliogiannis P, Mangoni AA. COVID-19 and IL-6 signaling: Diagnostic and prognostic implications. EJCM. 2022;4(1):15–23.
21. Montefusco L, Ben Nasr M, D’Addio F. Acute and long-term disruption of glycometabolic control in COVID-19 patients with diabetes. Nat Metab. 2021;3:774–85.
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Dr. Devanshu Shrivastava
BDS(MSc.in Medical Biochemistry), Index Medical College and Research Centre, Indore, Madhya Pradesh, India
Dr. Khushboo Upadhyaya
Assistant Professor in Deparment of Medical Physiology Index Medical College and hospital.(Msc Biotechnology ,M.sc Physiology,PhD Medical Physiology), Index Medical College and Research Centre, Indore, Madhya Pradesh, India,
Dr Ritika Malviya
Assistant Professor Index Medical college Indore Index Medical College and Research Centre, Indore, Madhya Pradesh, India, [email protected]
