My uncle's D-dimer level is high after COVID-19 treatment. Why?

Question

Hello doctor,

My uncle is 63 years old. He tested positive and had some issues with his oxygen level, so he was admitted to the hospital for around 15 days. He tested negative and was brought home. One day, the situation changed, and his sugar level was so high that it could not even be detected on the machine. He was immediately taken to the ICU. Once his 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 has been hospitalized for almost 40 days now and yet has not recovered completely.

He also has severe pain in his right leg, and he has 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 get a second opinion on this.

Why is his D-dimer level so high and taking a long time to reduce?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern, and I will definitely help you with it.

D-dimer is a portion of the blood-clotting proteins that gets elevated during increased clotting states like disseminated intravascular coagulation (DIC) (or simply widespread coagulation in various organs in the body). The latter also gets activated in this disease, as well as 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 the coronavirus comes back negative, then the chances of further D-dimer worsening are less, and as soon as it comes below a certain value, he is better off being discharged. Hoping for the best outcome.

WBC values are high and indicate increased inflammation, likely due to persistent disease infection

I hope it helped with the query.

Please let me know, and I will be happy to guide you further.

Thank you.