Study of Survival of COVID19 Patients with Severe or Critical Symptoms: Study of D-dimer on Survival of COVID19 Patients with Severe or Critical Degrees in ICU COVID, Academic Hospital, Gadjah Mada University, Yogyakarta

Purwadi Sujalmo(1*), Rosita Yunanda Purwanto(2), Rochmi Isnaini Rismawanti(3), Yanasta Yudo Pratama(4), Wandira Lalitya(5), Afridhia Bidari Fachrudin(6)

(1) Gadjah Mada University Academic Hospital
(2) 1. Faculty of Medicine, Public Health, and Nursing, Gadjah mada University 2. Gadjah Mada University Academic Hospital
(3) Gadjah Mada University Academic Hospital
(4) 1. Gadjah Mada University Academic Hospital 2. Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University 3. Faculty of Medicine, Universitas Islam Indonesia
(6) Faculty of Medicine, Universitas Islam Indonesia
(*) Corresponding Author


The SARS-CoV 2 virus pandemic has been a scourge since 2020. The number of cases that continues to increase, both mild, moderate, severe-critical confirmed cases are directly proportional to the need for treatment rooms, both ordinary wards and intensive care units (ICU), which is inversely proportional to the available capacity. room. Based on research, the high mortality and morbidity rate due to COVID 19 is due to the incidence of patient sepsis. Research abroad states that the value of D-dimer is a prognostic factor for COVID-19 patients, although there is no agreement on the best cut-off point for specificity and sensitivity. hypercoagulability conditions and increased lactic acid in patients with severe sepsis. It is necessary to evaluate the role of this laboratory result in estimating the prognosis of COVID-19 patients in Indonesia. There is no study that examines the relationship between the incidence of sepsis and the characteristics of hypercoagulability with the dominance of the thrombotic process in COVID19 patients in Indonesia. The purpose of this study was to provide information to health workers about the role of D-dimer value as a prognostic factor for severe-critical COVID-19 patients. This quantitative retrospective research data in the form of proportions were collected for 12 months from the medical records of the UGM Academic Hospital of patients with confirmed severe-critical COVID-19. Overall survival was assessed by the Kaplan-Meier curve. The cut-off determination for the D-dimer variable was carried out using the Receiver Operating Curve (ROC) followed by the calculation of the Youden index. Then the hazard ratio was determined by cox regression with a p value of <0.05 which was considered significant. Statistical analysis with SPSS version 26 software.


COVID19, AGD, D-dimer, Prognostic Factor

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World Health Organization. Archived: WHO Timeline - COVID-19 [Internet]. World Health Organization. 2020 [cited 2021 Feb 17]. Available from:

World Health Organization. Timeline: WHO’s COVID-19 response [Internet]. World Health Organization. 2020 [cited 2021 Feb 17]. Available from:!

World Health Organization. Who coronavirus disease (covid-19) dashboard [Internet]. World Health Organization. 2020 [cited 2022 Jan 2]. Available from:

Satuan Tugas Penanganan COVID-19. Peta Sebaran [Internet]. Satuan Tugas Penanganan COVID-19. 2020 [cited 2022 Jan 2]. Available from:

Oliveira E, Parikh A, Lopez-Ruiz A, Carrilo M, Goldberg J, Cearras M, et al. ICU outcomes and survival in patients with severe COVID-19 in the largest health care system in central Florida. PLoS ONE. 2021 Mar 1;16(3 March).

Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health — The latest 2019 novel coronavirus outbreak in Wuhan, China. Vol. 91, International Journal of Infectious Diseases. Elsevier B.V.; 2020. p. 264–6.

Yu T, Cai S, Zheng Z, Cai X, Liu Y, Yin S, et al. Association Between Clinical Manifestations and Prognosis in Patients with COVID-19. Clinical Therapeutics. 2020 Jun 1;42(6):964–72.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020 Mar 28;395(10229):1054–62.

Paliogiannis P, Mangoni AA, Dettori P, Nasrallah GK, Pintus G, Zinellu A. D-dimer concentrations and covid-19 severity: A systematic review and meta-analysis. Vol. 8, Frontiers in Public Health. Frontiers Media S.A.; 2020. p. 1–7.

Olson JD. D-dimer: An Overview of Hemostasis and Fibrinolysis, Assays, and Clinical Applications. In: Advances in Clinical Chemistry. Academic Press Inc.; 2015. p. 1–46.

Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, da Silva LFF, de Oliveira EP, Saldiva PHN, et al. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. Vol. 18, Journal of Thrombosis and Haemostasis. Blackwell Publishing Ltd; 2020. p. 1517–9.

Suh YJ, Hong H, Ohana M, Bompard F, Revel MP, Valle C, et al. Pulmonary Embolism and Deep Vein Thrombosis in COVID-19: A Systematic Review and Meta-Analysis. Vol. 298, Radiology. Radiological Society of North America Inc.; 2021. p. E70–80.

Poudel A, Poudel Y, Adhikari A, Aryal BB, Dangol D, Bajracharya T, et al. D-dimer as a biomarker for assessment of COVID-19 prognosis: D-dimer levels on admission and its role in predicting disease outcome in hospitalized patients with COVID-19. PLoS ONE. 2021 Aug 1;16(8 August 2021).

Biswas M, Rahaman S, Biswas TK, Haque Z, Ibrahim B. Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Vol. 64, Intervirology. S. Karger AG; 2021. p. 36–47.

Gemmati D, Bramanti B, Serino ML, Secchiero P, Zauli G, Tisato V. COVID-19 and individual genetic susceptibility/receptivity: Role of ACE1/ACE2 genes, immunity, inflammation and coagulation. might the double x-chromosome in females be protective against SARS-COV-2 compared to the single x-chromosome in males? International Journal of Molecular Sciences. 2020 May 2;21(10).

Nimgaonkar I, Valeri L, Susser E, Hussain S, Sunderram J, Aviv A. The age pattern of the male-to-female ratio in mortality from COVID19 mirrors that of cardiovascular disease in the general population. Impact Journals: Aging [Internet]. 2021 [cited 2021 Feb 17];13(3):3190–210. Available from:

Ng WH, Tipih T, Makoah NA, Vermeulen JG, Goedhals D, Sempa JB, et al. Comorbidities in SARS-CoV-2 patients: A systematic review and meta-analysis. mBio. 2021 Jan 1;12(1):1–12.

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis. International Journal of Infectious Diseases. 2020 May 1;94:91–5.

Sun X, Wang T, Cai D, Hu Z, Chen J, Liao H, et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Vol. 53, Cytokine and Growth Factor Reviews. Elsevier Ltd; 2020. p. 38–42.

Freites Nuñez DD, Leon L, Mucientes A, Rodriguez-Rodriguez L, Font Urgelles J, Madrid García A, et al. Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases. Annals of the Rheumatic Diseases. 2020 Nov 1;79(11):1393–9.

Ryan PMD, Caplice NM. Is Adipose Tissue a Reservoir for Viral Spread, Immune Activation, and Cytokine Amplification in Coronavirus Disease 2019? Vol. 28, Obesity. Blackwell Publishing Inc.; 2020. p. 1191–4.

Lemyze M, Courageux N, Maladobry T, Arumadura C, Pauquet P, Orfi A, et al. Implications of Obesity for the Management of Severe Coronavirus Disease 2019 Pneumonia. Critical Care Medicine. 2020;E761–7.


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