Introduction
Coronavirus disease- 19 (COVID-19), which shares similarities with SARS (Severe Acute Respiratory Syndrome) and Middle East Respiratory Syndrome (MERS) viruses responsible for endemic diseases in 2003 and 2012, is a novel beta corona virus 1-2. In addition to being a critical disease for health, coronavirus 2019 (COVID-19) poses a global threat 3.
First, pneumonia cases of unknown etiology occurred in Wuhan, Hubei province of China; the cases were reported to WHO (World Health Organization) in December 2019 and in March 2020 WHO declared this new infection as a pandemic 4-5.
COVID-19 is described as a new beta coronavirus. It is closely related to Severe Acute Respiratory Syndrome (SARS). It is a new infectious disease in which the virus is the causative pathogen5. Despite the presence of pulmonary pathophysiology during the disease, severe COVID-19 infection which is not fully understood is associated with pronounced alveolar inflammatory cell infiltration and it is accompanied by systemic cytokine storm6. One of the most important poor prognosis indicators is the development of coagulopathy in patients 7-8-9. Increased plasma levels of fibrin degradation D-dimers with COVID-19 infection constitute an independent biomarker for poor prognosis.⁹ In the COVID-19 pathogenesis of coagulation activation, significant pathological changes involving lung microvasculature including widespread micro thrombus and significant hemorrhagic necrosis have been highlighted, particularly in line with post mortem studies10-11.
Severe COVID-19 increases the risk of developing significantly associated deep vein thrombosis and pulmonary embolism12-13. For estimating the severity of COVID-19, monitoring of useful screening parameters for PLT, PT, aPTT and D-D (D-dimer) and daily changes in coagulation function is important in patients with COVID-19 14.
Poor prognosis that continues with COVID- 19 and continuation of D-dimer increase are precursors of multi organ failure and development of DIC (Disseminated Intravascular Coagulation) 15. Especially, high D-dimer level is associated with increased mortality. In patients who lost their lives, the increase is evident from the fourth day of hospitalization. Despite coagulopathy, hemorrhage findings are not a common biomarker 15-16-17.