Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Caesario, Jefferson, Hertanto, Decsa M., Hernugrahanto, Kukuh D., Utomo, Dwikora N., Budhiparama, Nicolaas C., Santoso, Djoko, Hogendoorn, Pancras C.W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000 Research Limited 2021
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
_version_ 1784654894214414336
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
work_keys_str_mv AT caesariojefferson casereportasymptomaticcovid19patientwithasubtlehypercoagulablestateandfluctuatingddimerlevel
AT hertantodecsam casereportasymptomaticcovid19patientwithasubtlehypercoagulablestateandfluctuatingddimerlevel
AT hernugrahantokukuhd casereportasymptomaticcovid19patientwithasubtlehypercoagulablestateandfluctuatingddimerlevel
AT utomodwikoran casereportasymptomaticcovid19patientwithasubtlehypercoagulablestateandfluctuatingddimerlevel
AT budhiparamanicolaasc casereportasymptomaticcovid19patientwithasubtlehypercoagulablestateandfluctuatingddimerlevel
AT santosodjoko casereportasymptomaticcovid19patientwithasubtlehypercoagulablestateandfluctuatingddimerlevel
AT hogendoornpancrascw casereportasymptomaticcovid19patientwithasubtlehypercoagulablestateandfluctuatingddimerlevel