High D-dimer and CRP Levels in an Asymptomatic COVID-19 Patient: A Case Report and Brief Literature Review

Gembong Satria Mahardhika, Theodore Dharma Tedjamartono, Prasetyo Widhi Buwono


SARS-CoV-2 is a highly transmittable virus and now declared as pandemic. Many of individuals infected by this novel coronavirus remain asymptomatic. The asymptomatic patients are challenging to manage because they could easily act as source of transmission and could also be at risk of worse outcome. Thrombosis is one of the factors associated with severe COVID-19 infection. In this report, we present a case of 60-year-old asymptomatic woman who was confirmed positive for COVID-19. Although asymptomatic, she had increased D-dimer and CRP level, which is associated with the risk of thrombosis. The patient was treated with standard regimen of oseltamivir, azithromycin, and vitamin B complex. Patient was given rivaroxaban 15 mg once a day for seven days in conjunction with elevated D-dimer level. On the last day of treatment, D-dimer level was decreased. The presence of high D-dimer in asymptomatic patients suggest that even with no symptoms, COVID-19 patients are at risk of worse outcome, for example, pulmonary embolism or venous thromboembolism due to prothrombic state induced by the infection. Thus, D-dimer and CRP monitoring are important in order to minimize the risk of thrombotic formation. Prophylactic anticoagulant might be given to patients with high risk of thrombotic events.

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