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Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level
Background: COVID-19 can infect an asymptomatic person silently without any overt symptoms despite diffuse blood clots throughout the body. Clot formation is induced by COVID-19 associated coagulopathy that can cause a high mortality rate. D-dimer, a fairly decisive marker for the coagulopathy event...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
F1000 Research Limited
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861469/ https://www.ncbi.nlm.nih.gov/pubmed/35251595 http://dx.doi.org/10.12688/f1000research.74009.1 |
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author | Caesario, Jefferson Hertanto, Decsa M. Hernugrahanto, Kukuh D. Utomo, Dwikora N. Budhiparama, Nicolaas C. Santoso, Djoko Hogendoorn, Pancras C.W. |
author_facet | Caesario, Jefferson Hertanto, Decsa M. Hernugrahanto, Kukuh D. Utomo, Dwikora N. Budhiparama, Nicolaas C. Santoso, Djoko Hogendoorn, Pancras C.W. |
author_sort | Caesario, Jefferson |
collection | PubMed |
description | Background: COVID-19 can infect an asymptomatic person silently without any overt symptoms despite diffuse blood clots throughout the body. Clot formation is induced by COVID-19 associated coagulopathy that can cause a high mortality rate. D-dimer, a fairly decisive marker for the coagulopathy event, is physiologically a marker of the fibrinolysis process. The increase of D-dimers in COVID-19 cases must be followed up because it relates to the initiation of a cytokine storm. Case presentation: We report an asymptomatic patient with sudden D-dimer elevation who received anticoagulant therapy. After three days of heparin administration, D-dimer results became normal and anticoagulant therapy was stopped. However, on the 12th day, the D-dimer level rebounded back and was followed by an increase of hs-C-reactive protein, erythrocyte sedimentation rate, IL-6, although SARS-CoV-2 PCR result became negative. A hyperglycaemic reaction and a sudden increase of HbA1C was observed in the patient. After three weeks D-dimer had returned to normal levels, and so did the other markers. The patient recovered fully and still no symptoms were obvious. Conclusion: COVID-19 patients without symptoms may be at risk of an asymptomatic coagulopathy process. The decreasing level of D-dimer erroneously cannot ensure that the coagulopathy process stops. |
format | Online Article Text |
id | pubmed-8861469 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | F1000 Research Limited |
record_format | MEDLINE/PubMed |
spelling | pubmed-88614692022-03-03 Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level Caesario, Jefferson Hertanto, Decsa M. Hernugrahanto, Kukuh D. Utomo, Dwikora N. Budhiparama, Nicolaas C. Santoso, Djoko Hogendoorn, Pancras C.W. F1000Res Case Report Background: COVID-19 can infect an asymptomatic person silently without any overt symptoms despite diffuse blood clots throughout the body. Clot formation is induced by COVID-19 associated coagulopathy that can cause a high mortality rate. D-dimer, a fairly decisive marker for the coagulopathy event, is physiologically a marker of the fibrinolysis process. The increase of D-dimers in COVID-19 cases must be followed up because it relates to the initiation of a cytokine storm. Case presentation: We report an asymptomatic patient with sudden D-dimer elevation who received anticoagulant therapy. After three days of heparin administration, D-dimer results became normal and anticoagulant therapy was stopped. However, on the 12th day, the D-dimer level rebounded back and was followed by an increase of hs-C-reactive protein, erythrocyte sedimentation rate, IL-6, although SARS-CoV-2 PCR result became negative. A hyperglycaemic reaction and a sudden increase of HbA1C was observed in the patient. After three weeks D-dimer had returned to normal levels, and so did the other markers. The patient recovered fully and still no symptoms were obvious. Conclusion: COVID-19 patients without symptoms may be at risk of an asymptomatic coagulopathy process. The decreasing level of D-dimer erroneously cannot ensure that the coagulopathy process stops. F1000 Research Limited 2021-11-03 /pmc/articles/PMC8861469/ /pubmed/35251595 http://dx.doi.org/10.12688/f1000research.74009.1 Text en Copyright: © 2021 Caesario J et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Caesario, Jefferson Hertanto, Decsa M. Hernugrahanto, Kukuh D. Utomo, Dwikora N. Budhiparama, Nicolaas C. Santoso, Djoko Hogendoorn, Pancras C.W. Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level |
title | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level |
title_full | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level |
title_fullStr | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level |
title_full_unstemmed | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level |
title_short | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level |
title_sort | case report: asymptomatic covid-19 patient with a subtle hypercoagulable state and fluctuating d-dimer level |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861469/ https://www.ncbi.nlm.nih.gov/pubmed/35251595 http://dx.doi.org/10.12688/f1000research.74009.1 |
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