Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved]
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...
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2021-11-01
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| Online Access: | https://f1000research.com/articles/10-1112/v1 |
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| author | Jefferson Caesario Decsa M. Hertanto Kukuh D. Hernugrahanto Dwikora N. Utomo Nicolaas C. Budhiparama Djoko Santoso Pancras C.W. Hogendoorn |
| author_facet | Jefferson Caesario Decsa M. Hertanto Kukuh D. Hernugrahanto Dwikora N. Utomo Nicolaas C. Budhiparama Djoko Santoso Pancras C.W. Hogendoorn |
| author_sort | Jefferson Caesario |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-13T13:47:58Z |
| format | Article |
| id | doaj.art-c6b1e8da83634f48b062533752091317 |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-12-13T13:47:58Z |
| publishDate | 2021-11-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-c6b1e8da83634f48b0625337520913172022-12-21T23:43:20ZengF1000 Research LtdF1000Research2046-14022021-11-011077714Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved]Jefferson Caesario0https://orcid.org/0000-0002-2183-9804Decsa M. Hertanto1https://orcid.org/0000-0002-3639-2152Kukuh D. Hernugrahanto2Dwikora N. Utomo3Nicolaas C. Budhiparama4Djoko Santoso5Pancras C.W. Hogendoorn6Faculty of Medicine, Airlangga University, Surabaya, 60286, IndonesiaDepartment of Internal Medicine, Faculty of Medicine, Airlangga University, Surabaya, 60286, IndonesiaDepartment of Orthopaedic & Traumatology, Faculty of Medicine, Airlangga University, Surabaya, 60286, IndonesiaNicolaas Institute of Constructive Orthopaedic Research and Education Foundation for Arthroplasty and Sports Medicine, Medistra Hospital, Jakaarta, 12950, IndonesiaDepartment of Orthopaedic Surgery, Leiden University Medical Center, Leiden, 2333, The NetherlandsFaculty of Vocational Studies, Airlangga University, Surabaya, 60286, IndonesiaDepartment of Pathology, Leiden University Medical Center, Leiden, 2333, The NetherlandsBackground: 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.https://f1000research.com/articles/10-1112/v1COVID-19 Coagulopathy Asymptomatic D-dimer Anticoagulant Therapyeng |
| spellingShingle | Jefferson Caesario Decsa M. Hertanto Kukuh D. Hernugrahanto Dwikora N. Utomo Nicolaas C. Budhiparama Djoko Santoso Pancras C.W. Hogendoorn Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved] F1000Research COVID-19 Coagulopathy Asymptomatic D-dimer Anticoagulant Therapy eng |
| title | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved] |
| title_full | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved] |
| title_fullStr | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved] |
| title_full_unstemmed | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved] |
| title_short | Case Report: Asymptomatic COVID-19 patient with a subtle hypercoagulable state and fluctuating D-dimer level [version 1; peer review: 2 approved] |
| title_sort | case report asymptomatic covid 19 patient with a subtle hypercoagulable state and fluctuating d dimer level version 1 peer review 2 approved |
| topic | COVID-19 Coagulopathy Asymptomatic D-dimer Anticoagulant Therapy eng |
| url | https://f1000research.com/articles/10-1112/v1 |
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