Dr. Shubadeep Debabrata Sinha
Infectious Diseases
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Patient's Query
Hello doctor,
My uncle is 63 years old. He was detected positive and had some issues with the oxygen level so was admitted to the hospital for around 15 days. He was tested negative and brought home. In a day the situation changed and his sugar level was high that it could not even get detected on the machine. He was immediately taken to ICU, once her BP level is managed now, we see his D-dimer level fluctuating around 6000 to 4000 which eventually affects his blood pressure as well. He is hospitalized for almost 40 days now and yet has not recovered completely.
He also has severe pain in his right leg, and he had rheumatoid arthritis. The medication related to it was not given during COVID-19 treatment, but now they have started again. The leg pain has been reduced but the D-dimer level is still high. Doctors are saying that once it is around 700 we can take him home. I would like to take a second opinion on this. Why his D- Dimer level is so high and taking a long to reduce?
Hello,
Welcome to icliniq.com.
D-dimer is a portion of the blood clotting proteins that get elevated during increased clotting states like disseminated intravascular coagulation (DIC) (or simply widespread coagulation in various organs in the body). The latter gets also activated in this disease, as well due to widespread infection, and is roughly a marker of disease severity as well as chances of increased risk. To manage this condition, anticoagulants like Clexane and anti-inflammatory drugs like steroids and Tocilizumab are given. These values must go down significantly to reduce the risk. Since he is an elderly person, it is getting delayed. Plus he has rheumatoid arthritis, an autoimmune disease with similar inflammatory blood factors, which is probably now delaying the process. If Coronavirus comes negative, then the chances of further D-dimer worsening is less, and as soon as it comes below a certain value, he is better to be discharged. Hoping for the best outcome.
WBC values are high and indicate increased inflammation likely due to persistent disease infection
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