Among coagulation tests, which has been associated with mortality in COVID-19?

Among coagulation tests, which has been associated with mortality in COVID-19?

• A. Thrombin Time
• B. D-Dimer
• C. PT
• D. aPTT

Answer: (B)

In COVID-19, the strongest clue that mortality risk is higher is an elevated D-dimer. D-dimer is a byproduct released when cross-linked fibrin is broken down, so higher levels signal ongoing clot formation and breakdown—a marker of a hypercoagulable and inflammatory state. In many studies, patients with higher D-dimer on admission or rising levels during hospitalization have worse outcomes, including higher rates of ICU admission, thrombotic events, and death. That direct link between active thrombosis/fibrinolysis and severe disease makes D-dimer the test most consistently associated with mortality in COVID-19. Thrombin time, while useful for assessing fibrinogen conversion to fibrin and sometimes affected by anticoagulants or fibrinogen abnormalities, does not track overall thrombotic burden or prognosis as reliably. PT and aPTT evaluate clotting times via specific pathways, but their values can be influenced by factors like liver function, inflammation, or anticoagulation and don’t correlate as clearly with mortality risk in COVID-19 as D-dimer does.

In COVID-19, the strongest clue that mortality risk is higher is an elevated D-dimer. D-dimer is a byproduct released when cross-linked fibrin is broken down, so higher levels signal ongoing clot formation and breakdown—a marker of a hypercoagulable and inflammatory state. In many studies, patients with higher D-dimer on admission or rising levels during hospitalization have worse outcomes, including higher rates of ICU admission, thrombotic events, and death. That direct link between active thrombosis/fibrinolysis and severe disease makes D-dimer the test most consistently associated with mortality in COVID-19.

Thrombin time, while useful for assessing fibrinogen conversion to fibrin and sometimes affected by anticoagulants or fibrinogen abnormalities, does not track overall thrombotic burden or prognosis as reliably. PT and aPTT evaluate clotting times via specific pathways, but their values can be influenced by factors like liver function, inflammation, or anticoagulation and don’t correlate as clearly with mortality risk in COVID-19 as D-dimer does.