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Year : 2022  |  Volume : 25  |  Issue : 9  |  Page : 1418-1423

A novel combined index of D-dimer, fibrinogen, albumin, and platelet (FDAPR) as mortality predictor of COVID-19

1 Department of Medical Biochemistry, Medical Faculty of Tekirdağ Namık Kemal University, Tekirdağ, Turkey
2 İnfectious Diseases and Clinical Microbiology Department, Çorlu State Hospital Tekirdağ, Tekirdağ, Turkey
3 Department of Family Medicine, Medical Faculty of Tekirdağ Namık Kemal University, Tekirdağ, Turkey
4 Medical Microbiology Department, Medical Faculty of Tekirdağ Namık Kemal University, Tekirdağ, Turkey
5 Medical Biochemistry Department, Cerrahpaşa Medical Faculty of İstanbul University, İstanbul, Turkey

Correspondence Address:
Dr. A Celikkol
Medical Faculty of Tekirdağ Namık Kemal University, Clinical Biochemistry Department, Değirmenaltı mah. Kampüs cad. 59030 Süleymanpaşa/Tekirdağ
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njcp.njcp_1633_21

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Background: In coronavirus disease 2019 (COVID-19) caused by SARSCoV2 viruses, coagulation abnormalities are strongly correlated between disease severity and mortality risk. Aims: The aim was to search for new indices to determine mortality risk. Fibrinogen times D-dimer to albumin times platelet ratio calculated with the formula (FDAPR index: ((Fibrinogen × D-dimer)/(Albumin × Platelet)) investigated as a mortality marker in COVID-19 patients. The hospitalization data of 1124 patients were analyzed from the electronic archive system. Hemogram, coagulation, and inflammatory markers were investigated in the study group. Materials and Methods: All statistical analyses like the student t-test, Mann–Whitney U, Kaplan–Meier, and Cox hazard ratio, were performed with the SPSS 22.0 program. Results: Prothrombin time was prolonged significantly in patients (P < 0.05) compared to healthy subjects (n = 30). D-dimer and fibrinogen were high, and albumin and platelet counts were low in COVID-19 patients (all, P < 0.001). When the data of 224 non-survivors and 900 survived patients were compared, D-dimer and fibrinogen were higher, and albumin and platelet lower (all, P < 0.001) compared to mild and severe patients. At the cut-off value of 0.49, the FDAPR index was performed with 89.1% sensitivity and 88.6% specificity. FDAPR index had the highest mortality predictive power (P < 0.01; HR = 5.366; 95% CI; 1.729–16.654). Conclusions: This study revealed that the FDAPR index could be used as a mortality marker of COVID-19 disease.

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