New recommendations from the ISTH
In new guidance published recently by the International Society on Thrombosis and Haemostasis, D-Dimer (among other coagulation tests) is recommended as a routine stratification tool upon admission to hospital.
The new document is produced by experts from a variety of renowned institutions including Manchester University Hospitals and Huazhong University of Science and Technology. It discusses how, despite the majority of the most severely ill patients initially presenting with single organ failure, some of them progress to more systemic disease and multiple organ dysfunction. One of the most significant poor prognostic features in those patients is the development of coagulopathy.
Also mentioned are recent studies indicating that one of the commonest laboratory findings noted in COVID-19 patients requiring hospitalisation has been the increase in D-dimers. It is already well-established that older individuals and those who have co-morbidities — both of which tend to have higher D-dimer — are more likely to die from COVID-19 infection.
As the guidance says:
“ we would recommend measuring D-dimers, prothrombin time and platelet count (decreasing order of importance) in all patients who present with COVID-19 infection. This may help in stratifying patients who may need admission and close monitoring or not.”
The guidance goes on to recommend how D-Dimer can be used with a range of other tests including prothrombin time, platelet count and fibrinogen can be used to help stratify patients upon admission.
You can read the full ISTH guidance here.
Quantitative testing for deep-vein thrombosis, pulmonary embolism and more on Sysmex, IL and Behnk automated coagulation platforms, with a manual latex-based kit for rapid point-of-care use.
21 April 2020 18:17