Association Between aPTT Value and

Pulmonary Embolism Event in COVID-19

Patients Receiving Heparin Prophylaxis in the
Isolation ICU of Pertamina Central Hospital
Rengga Sebastian1, Alvin Johan1, Manzilina Mudia1
1Pertamina Central Hospital

BACKGROUND
Pulmonary embolism (PE) is blockage of pulmonary artery usually caused by blood clot
and has high mortality rate. Heparin is used as a prophylactic agent to prevent PE.
Heparin dose is adjusted according to the Activated partial thromboplastin time (aPTT)
value to achieve  1,5 times the baseline control value.
GROUP[n(%)]
CHARACTERISTICS CASE CONTROL OBJECTIVE
N = 25 N=25 To determine the association of aPTT
Age, years (Mean ± SD) 59 (12.84) 62 (12.92) value and PE event in COVID-19
Gender
Patients.
Male 16 (64) 13 (52)
Female 9 (36) 12 (48)
BMI METHOD
>=25 kg/m2 12 (48) 8 (32) We conducted a retrospective
<25 kg/m2 13 (52) 17 (68)
Comorbidity
unmatched case-control study at the
Previous DVT/PE 1 (4) 0 (0) Isolation ICU of Pertamina Central
Active Malignant
2 (8) 0 (0)
Hospital. Data was taken from medical
Condition records in September 2020 - May 2021
Sepsis Shock 5 (20) 0 (0)
Hypertension 8 (32) 13 (52)
period. Case group was patients with
Diabetes Mellitus 11 (44) 8 (32) echocardiographic findings consistent
Revised Ganeva Score with PE. Samples were collected with
0-3 (low probability) 0 (0) 17 (68)
total sampling for the case group and
4-10 (moderate
probability)
25 (100) 8 (32) simple random sampling for the control
>=11 (high probability) 0 (0) 0 (0) group. The analysis was calculated with
D-Dimer [Median(IQR)] 6.11 (2.75-8.41 2.21 (1.14-4.41) IBM SPSS Statistic 24 software.

RESULT
A total of 25 cases and 25 controls were included in this study. In the case group, 25 (100%) patients
had Revised Geneva Score of 4-10 (moderate probability of PE) while only 8 (32%) patients in the
control group. Median D-dimer value for case group was 6.11 (2.75-8.41) vs 2.21 (1.14-4.41) in the
control group. The targeted APTT value was not reached in 12 (48%) of the patient with PE compared
to 6 (24%) of the control patients. The odds ratio of PE for targeted APTT not reached versus targeted
APTT reached was 2,923 (95% CI, 0,874 - 9,778).

CONCLUSION
There was no association between APTT level and PE event in COVID-19 patients
receiving heparin prophylaxis.
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