The emergence of the novel Coronavirus disease, (COVID-19) pandemic has become an urgent issue of public health concern in every country. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The morbidity and mortality of this disease is frightening. As at Friday 20/05/2022, according to WHO report, 527,857,379 individuals have been infected and 6,301,116 deaths recorded globally, with 255,937 cases and 3,143 fatalities recorded respectively in Nigeria.
It was initially thought to affect the respiratory system only; however, as at present other organ and system-specific manifestations are being observed. Such other system includes the haematological and haemostasis system. Altered haemostasis manifesting as coagulopathy is seen in 50% of severe cases and has been reported to be the major cause of death in infected persons. The causes of coagulopathy are seen to be the formation of micro-clot in the blood vessels, consumption of platelets, excessive activation of fibrinolysis, and consumption of coagulation factors due to exaggerated inflammatory response. The coagulopathy appears to be unique and distinct from sepsis-induced coagulopathy, disseminated intravascular coagulation (DIC), and other viral infection-induced coagulation abnormalities.
Severe thrombocytopenia, raised D-dimer, and elevated levels of fibrin/fibrinogen degradation products are the hallmark of the coagulation defect. Other associated features include modest or no change in activated partial thromboplastin time and prothrombin time, elevated levels of fibrinogen, factor VIII, and von Willebrand factor. D-dimer and thrombocytopenia had been shown to correlate with disease severity.
This course aims to draw the attention of caregivers to appreciate the strong relationship that exists between COVID-19 and coagulation parameters, D-dimer, and platelet count in particular. These coagulation biomarkers are useful tools in predicting COVID19 infection, monitoring treatment, and determining disease severity. Therefore, the biomarkers are of value in early diagnosis, management, and disease containment strategy. The simplicity of testing techniques, their cost effectiveness, the availability of the reagents, good turnaround time and less invasive procedure in sample collection are a veritable tool in management and containment strategy as against the conventional diagnostic approaches which largely focus on nucleic acid testing for acute phase disease which is not only time consuming but also expensive in monetary and skills requirements.