tetano
Editor, Senior Moderator
Cardiol Rev
. Nov/Dec 2020;28(6):295-302.
doi: 10.1097/CRD.0000000000000330.
Elevated D-Dimer Levels Are Associated With Increased Risk of Mortality in Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Siddharth Shah[SUP] 1 [/SUP], Kuldeep Shah[SUP] 2 [/SUP], Siddharth B Patel[SUP] 3 [/SUP], Foram S Patel[SUP] 4 [/SUP], Mohammed Osman[SUP] 2 [/SUP], Poonam Velagapudi[SUP] 5 [/SUP], Mohit K Turagam[SUP] 6 [/SUP], Dhanunjaya Lakkireddy[SUP] 7 [/SUP], Jalaj Garg[SUP] 8 [/SUP]
Affiliations
Abstract
The 2019 novel coronavirus, declared a pandemic, has infected 2.6 million people as of April 27, 2020, and has resulted in the death of 181,938 people. D-dimer is an important prognostic tool, is often elevated in patients with severe coronavirus disease-19 (COVID-19) infection and in those who suffered death. In this systematic review, we aimed to investigate the prognostic role of D-dimer in COVID-19-infected patients. We searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting admission D-dimer levels in COVID-19 patients and its effect on mortality. Eighteen studies (16 retrospective and 2 prospective) with a total of 3682 patients met the inclusion criteria. The pooled weighted mean difference (WMD) demonstrated significantly elevated D-dimer levels in patients who died versus those who survived (WMD, 6.13 mg/L; 95% confidence interval [CI] 4.16-8.11; P < 0.001). Similarly, the pooled mean D-dimer levels were significantly elevated in patients with severe COVID-19 infection (WMD, 0.54 mg/L; 95% CI 0.28-0.80; P < 0.001). The risk of mortality was fourfold higher in patients with positive D-dimer versus negative D-dimer (risk ratio, 4.11; 95% CI, 2.48-6.84; P < 0.001) and the risk of developing severe disease was twofold higher in patients with positive D-dimer levels versus negative D-dimer (risk ratio, 2.04; 95% CI, 1.34-3.11; P < 0.001). Our meta-analysis demonstrates that patients with COVID-19 infection presenting with elevated D-dimer levels have an increased risk of severe disease and mortality.
. Nov/Dec 2020;28(6):295-302.
doi: 10.1097/CRD.0000000000000330.
Elevated D-Dimer Levels Are Associated With Increased Risk of Mortality in Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Siddharth Shah[SUP] 1 [/SUP], Kuldeep Shah[SUP] 2 [/SUP], Siddharth B Patel[SUP] 3 [/SUP], Foram S Patel[SUP] 4 [/SUP], Mohammed Osman[SUP] 2 [/SUP], Poonam Velagapudi[SUP] 5 [/SUP], Mohit K Turagam[SUP] 6 [/SUP], Dhanunjaya Lakkireddy[SUP] 7 [/SUP], Jalaj Garg[SUP] 8 [/SUP]
Affiliations
- PMID: 33017364
- DOI: 10.1097/CRD.0000000000000330
Abstract
The 2019 novel coronavirus, declared a pandemic, has infected 2.6 million people as of April 27, 2020, and has resulted in the death of 181,938 people. D-dimer is an important prognostic tool, is often elevated in patients with severe coronavirus disease-19 (COVID-19) infection and in those who suffered death. In this systematic review, we aimed to investigate the prognostic role of D-dimer in COVID-19-infected patients. We searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting admission D-dimer levels in COVID-19 patients and its effect on mortality. Eighteen studies (16 retrospective and 2 prospective) with a total of 3682 patients met the inclusion criteria. The pooled weighted mean difference (WMD) demonstrated significantly elevated D-dimer levels in patients who died versus those who survived (WMD, 6.13 mg/L; 95% confidence interval [CI] 4.16-8.11; P < 0.001). Similarly, the pooled mean D-dimer levels were significantly elevated in patients with severe COVID-19 infection (WMD, 0.54 mg/L; 95% CI 0.28-0.80; P < 0.001). The risk of mortality was fourfold higher in patients with positive D-dimer versus negative D-dimer (risk ratio, 4.11; 95% CI, 2.48-6.84; P < 0.001) and the risk of developing severe disease was twofold higher in patients with positive D-dimer levels versus negative D-dimer (risk ratio, 2.04; 95% CI, 1.34-3.11; P < 0.001). Our meta-analysis demonstrates that patients with COVID-19 infection presenting with elevated D-dimer levels have an increased risk of severe disease and mortality.