Reaction of coagulopathy markers in patients with long bone fractures in the setting of COVID–19

Abstract

Objective. To study the dynamics of the level of the diagnostic marker D–dimer to characterize the course of COVID–19 and early diagnosis of thromboembolic complications in patients with long bone fractures.

Materials and methods. To fulfill the objectives of the study, a retrospective array of 289 patients with skeletal fractures treated at the Kyiv City Clinical Emergency Hospital from March 2020 to February 2021 was formed. The main group included 157 patients with skeletal fractures in the setting of COVID–19, and the control group included 132 patients with skeletal fractures without COVID–19.

Results. On the 1st day of treatment, 45.9% of patients in the main group had high levels of D–dimer, while among patients in the control group such results were recorded more than 4 times less often. Extremely high levels of D–dimer were observed in 26.0% of patients in the main group, and no such patients were found in the control group. On the 3rd day of treatment, 53.5% of patients in the main group had high levels of D–dimer, which was 5.5 times more frequent than in the control group. Extremely high levels of D–dimer were observed in 26.7% of patients in the main group and were not observed in the control group. On the 10th day of treatment, normal and subnormal levels of D–dimer were detected in 44.0% of patients in the main group, but this is more than twice as rare as in the control group. High levels of D–dimer were found in 49.0% of patients in the main group and only 3.0% of patients in the control group.

Conclusions. Initial levels of D–dimer have a prognostic value for detecting thromboembolic complications at the earliest possible time.

Peak D–dimer values are determined on day 3 of treatment and tend to decrease on day 10. High levels of D–dimer in patients with long bone fractures in the setting of COVID–19 have the value of an unfavorable prognostic factor, but this thesis requires additional research.