D-Dimer, Activated Partial Thromboplastin Time, and Prothrombin Time Comparison in Different Severity Levels of COVID-19 in Pregnancy: A Single Center Study

Background &  Uncertainties exist about the diagnostic and prognostic role of hemocytometry values in patients with COVID-19 especially in pregnancy. This study aims to investigate hemostatic changes in pregnant woman with coronavirus disease (COVID-19) and their relationship to disease severity.Materials &  This research is an analytic observational study with case control design. Subject was gathered from Hasan Sadikin General Hospital Bandung, Indonesia patients' medical records from June 2021 – March 2022. Inclusion criteria for this study are all pregnant COVID-19 patients with prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer examination. The exclusion of this study, all pregnant COVID-19 patients without required examination. PT, aPTT, and D-dimer were measured by Stago kits on a Stago automated coagulation analyzer (STA Compact Max®). Data was then analyzed by Kruskal Wallis with IBM SPSS Statistic 26th with α=0.05. Statistical analysis shows there’s correlation between different severity levels with D-Dimer. This study shows the mean of D-Dimer of each severity levels; asymptomatic 4.85 mg/L, mild 2.86 mg/L, moderate 5.47 mg/L and severe 14.51 mg/L (p <0.000). Changes seen after mild group which increase to 5.47 mg/dL in moderate COVID-19 and furthermore increase in severe become 14.51 mg/L. No changes in PT and aPTT were found. In conclusion, our findings demonstrate that coagulopathy is associated with the severity of COVID-19 illness. D-dimer is an important parameter for evaluating the COVID-19 severity in pregnancy. This further could serve as a diagnostic category to differ the severity of COVID-19 in pregnancy.