Increased D-Dimer value as a marker of pulmonary arterythrombosis in COVID 19 pneumonia

Background: COVID-19 has been well described as the cause fora proinflammatory and hypercoagulable state: the endothelialcells damage and the release of a large amount of inflammatorymediators may predispose to vascular thrombosis Materials and Methods: We evaluated 138 patients with COVID19 admitted to our Institution between March 2020 and May 2020 At admission, most of them were haemodinamically stable andfebrile All patients were treated with hydroxychloroquine (400mg/day), darunavir/ritonavir (800/100 mg/day) and enoxaparin(4000 UI/day) Every three days, laboratory exams with inflammatory and coagulation parameters (INR, activated partial thromboplastin time, platelets count, fibrinogen, D-Dimer) were repeated Inthe patients with progressive elevation of D-Dimer and low or normalvalues of other coagulation or inflammatory blood parameters weperformed a computed tomography pulmonary angiography (CTPA)and Doppler ultrasound of the lower limbs Results: We identify patients with signs of bilaterally pulmonaryartery thrombosis (APT) in absence of deep venous thrombosis Patients did not have signs of respiratory failure and breath onroom air We compared D-Dimer value at the admission in patientswith and without APT to identify whether it can have a negativeprognostic value and we saw no relevant differences Conclusions: In conclusion, we described patients with moderatedisease who developed a pulmonary vascular injury strictly correlated with an elevation of D-Dimer values The development of theAPT was not related to D-dimer value at the admission but only tothe increase