A biological variation-based approach to the day-to-day changes of D-dimer, Fibrinogen, and Ferritin levels that are crucial in the clinical course of COVID-19 in healthy smokers and non-smokers

Abstract

Objective D-dimer, ferritin, and fibrinogen parameters in COVID-19 patients are essential, particularly in inpatients and intensive care unit patients. It is vital to know the changes that occur due to the biological structure of the person than the disease effect in these tests to manage the fatal disease better. Method Blood samples were taken on the first, third, and fifth days from 30 healthy volunteers, 15 of whom were smokers, 15 were non-smokers, and D-dimer, ferritin, and fibrinogen tests were studied with repeated measurements. After the data was processed for normality and homogeneity and removing extreme values, CVA, CVI, CVG, CVT, RCV, II, I%, B%, TE% values were calculated via a complete nested ANOVA design, according to Callum G, Fraser, and EFLM. Results CVI and CVG values of D-dimer were calculated as 49.07% and 40.69% for all individuals, 49.26% and 27.71% for smokers, 48.80% and 51.67% for non-smokers, respectively. In terms of fibrinogen, the same analyzes for all individuals were calculated as 11.18% and 10.62%, 3.25% and 20.17% for smokers, 9.11% and 6.79% for non-smokers, respectively. The same ferritin analyses were calculated as 23.74% and 63.31% for all individuals, 34.98% and 35.24% for smokers, 30.53% and 74.87% for non-smokers, respectively. Conclusion Changes in D-dimer measurements every other day in healthy individuals can be observed depending on the biological characteristics of the individuals, and the population-based reference interval may be insufficient for clinical evaluation. Therefore, each individual should be evaluated within themselves. When assessing the results of ferritin and fibrinogen in non-smoking individuals, it should be taken into account that significant differences may occur between individuals. Besides, it should be kept in mind that there may be considerable changes due to biological variation in the repeated measurements of ferritin every other day.