tetano
Editor, Senior Moderator
Clin Appl Thromb Hemost
. Jan-Dec 2021;27:10760296211057901.
doi: 10.1177/10760296211057901.
Diagnostic Accuracy of D-Dimers for Predicting Pulmonary Embolism in COVID-19-Patients
Falmata Laouan Brem[SUP] 1 [/SUP], Boudouh Asmae[SUP] 2 [/SUP], Yassine Amane[SUP] 3 [/SUP], Mohammed-Amine Bouazzaoui[SUP] 4 [/SUP], Miri Chaymae[SUP] 1 [/SUP], Hammam Rasras[SUP] 1 [/SUP], Siham Nasri[SUP] 3 [/SUP], Naima Abda[SUP] 4 [/SUP], Imane Skiker[SUP] 3 [/SUP], Hatim Kouismi[SUP] 2 [/SUP], Bazid Zakaria[SUP] 1 4 [/SUP], Nabila Ismaili[SUP] 1 4 [/SUP], Noha El Ouafi[SUP] 1 4 [/SUP]
Affiliations
Abstract
Importance: Proinflammatory and hypercoagulable states with marked elevation seen in D-Dimer levels have been accurately described in patients infected by the SARS- Cov2 even without pulmonary embolism (PE).
Objectives: To compare D-dimers values in patients infected by the novel Coronavirus 2019 (COVID-19) with and without PE and to establish an optimal D-dimer cut-off to predict the occurrence of PE, which guides pulmonary computed tomography angiography (CTPA) indication.
Methods: We retrospectively enrolled all COVID-19-patients admitted between October first and November 22th, 2020, at the University Hospital Center of Mohammed VI, Oujda (Morocco), suspected to have PE and underwent a CTPA. Demographic characteristics and blood test results were compared between PE-positive and PE-negative. The receiver operating characteristics (ROC) curve was constructed to establish an optimal D-Dimer cut-off to predict the occurrence of PE.
Results: The study population consisted of 84 confirmed COVID-19-patients. The mean age was 64.93 years (SD 14.19). PE was diagnosed on CTPA in 31 (36.9%) patients. Clinical symptoms and in-hospital outcomes were similar in both groups except that more men had PE (p = .025). The median value of D-dimers in the group of patients with PE was significantly higher (14 680[IQR 33620-3450]ng/mL compared to the group of patients without PE 2980[IQR 6870-1600]ng/mL [P < .001]. A D-dimer at 2600 ng/mL was the optimal cut-off for predicting PE with a sensitivity of 90.3%, and AUC was .773[CI 95%, .667 -.876).
Conclusion: A D-dimer cut-off value of 2600 ng/mL is a significant predictor of PE in COVID-19-patients with a sensitivity of 90.3%.
Keywords: COVID-19; coagulopathy; d-dimers; pulmonary embolism; threshold.
. Jan-Dec 2021;27:10760296211057901.
doi: 10.1177/10760296211057901.
Diagnostic Accuracy of D-Dimers for Predicting Pulmonary Embolism in COVID-19-Patients
Falmata Laouan Brem[SUP] 1 [/SUP], Boudouh Asmae[SUP] 2 [/SUP], Yassine Amane[SUP] 3 [/SUP], Mohammed-Amine Bouazzaoui[SUP] 4 [/SUP], Miri Chaymae[SUP] 1 [/SUP], Hammam Rasras[SUP] 1 [/SUP], Siham Nasri[SUP] 3 [/SUP], Naima Abda[SUP] 4 [/SUP], Imane Skiker[SUP] 3 [/SUP], Hatim Kouismi[SUP] 2 [/SUP], Bazid Zakaria[SUP] 1 4 [/SUP], Nabila Ismaili[SUP] 1 4 [/SUP], Noha El Ouafi[SUP] 1 4 [/SUP]
Affiliations
- PMID: 34905979
- DOI: 10.1177/10760296211057901
Abstract
Importance: Proinflammatory and hypercoagulable states with marked elevation seen in D-Dimer levels have been accurately described in patients infected by the SARS- Cov2 even without pulmonary embolism (PE).
Objectives: To compare D-dimers values in patients infected by the novel Coronavirus 2019 (COVID-19) with and without PE and to establish an optimal D-dimer cut-off to predict the occurrence of PE, which guides pulmonary computed tomography angiography (CTPA) indication.
Methods: We retrospectively enrolled all COVID-19-patients admitted between October first and November 22th, 2020, at the University Hospital Center of Mohammed VI, Oujda (Morocco), suspected to have PE and underwent a CTPA. Demographic characteristics and blood test results were compared between PE-positive and PE-negative. The receiver operating characteristics (ROC) curve was constructed to establish an optimal D-Dimer cut-off to predict the occurrence of PE.
Results: The study population consisted of 84 confirmed COVID-19-patients. The mean age was 64.93 years (SD 14.19). PE was diagnosed on CTPA in 31 (36.9%) patients. Clinical symptoms and in-hospital outcomes were similar in both groups except that more men had PE (p = .025). The median value of D-dimers in the group of patients with PE was significantly higher (14 680[IQR 33620-3450]ng/mL compared to the group of patients without PE 2980[IQR 6870-1600]ng/mL [P < .001]. A D-dimer at 2600 ng/mL was the optimal cut-off for predicting PE with a sensitivity of 90.3%, and AUC was .773[CI 95%, .667 -.876).
Conclusion: A D-dimer cut-off value of 2600 ng/mL is a significant predictor of PE in COVID-19-patients with a sensitivity of 90.3%.
Keywords: COVID-19; coagulopathy; d-dimers; pulmonary embolism; threshold.