tetano
Editor, Senior Moderator
Front Pharmacol
. 2020 Dec 21;11:600592.
doi: 10.3389/fphar.2020.600592. eCollection 2020.
D-Dimer as a Prognostic Indicator in Critically Ill Patients Hospitalized With COVID-19 in Leishenshan Hospital, Wuhan, China
Jinpeng Li[SUP] 1 [/SUP], Zeming Liu[SUP] 2 [/SUP], Gaosong Wu[SUP] 1 [/SUP], Meilin Yi[SUP] 3 [/SUP], Yongfeng Chen[SUP] 4 [/SUP], Kun Li[SUP] 5 [/SUP], Xiaoming Xu[SUP] 6 [/SUP], Linqi Xiao[SUP] 7 [/SUP], Qian Wu[SUP] 8 [/SUP], Jincao Chen[SUP] 8 [/SUP], Xiaohui Wu[SUP] 8 [/SUP]
Affiliations
Abstract
Background: D-dimer is a small protein fragment and high levels of D-dimer have been associated with increased mortality in patients presenting to emergency departments with infection. Previous studies have reported increased levels of D-dimer in COVID-19; however, it is unclear whether an increased D-dimer level provides early warning of poor prognosis. Therefore, this study aimed to assess the usefulness of D-dimer as an early indicator of prognosis in patients with coronavirus disease (COVID-19). Methods: We conducted a retrospective study of patients with COVID-19 admitted to Leishenshan Hospital in Wuhan, China, from February 15 to March 30, 2020. The final date of follow-up was April 11, 2020. Results: Of the 1,643 patients with COVID-19, 691 had elevated D-dimer levels. Their median age was 65 years. Of the patients with elevated D-dimer levels, 45% had comorbidities, with cardiovascular disease (205 [29.7%]) being the most common. Patients with elevated D-dimer were more likely to require treatment with high-flow oxygen, anticoagulation, antibiotics, and admission to the intensive care unit They were also more likely to have increased interleukin-6, monocytes, and lymphocytes. Patients with elevated D-dimer levels had significantly higher mortality than those with normal or low D-dimer levels. Conclusion: In patients with COVID-19, elevated D-dimer was associated with abnormal immunity, underlying disease, increased disease severity, and increased mortality. Taken together, D-dimer may be a marker for the early warning of disease severity and increased risk of death. These findings provide insights into the potential risk of elevated D-dimer in patients with COVID-19.
Keywords: COVID-19; SARS–CoV–2; critically ill patients; d-dimer; prognostic indicator.
. 2020 Dec 21;11:600592.
doi: 10.3389/fphar.2020.600592. eCollection 2020.
D-Dimer as a Prognostic Indicator in Critically Ill Patients Hospitalized With COVID-19 in Leishenshan Hospital, Wuhan, China
Jinpeng Li[SUP] 1 [/SUP], Zeming Liu[SUP] 2 [/SUP], Gaosong Wu[SUP] 1 [/SUP], Meilin Yi[SUP] 3 [/SUP], Yongfeng Chen[SUP] 4 [/SUP], Kun Li[SUP] 5 [/SUP], Xiaoming Xu[SUP] 6 [/SUP], Linqi Xiao[SUP] 7 [/SUP], Qian Wu[SUP] 8 [/SUP], Jincao Chen[SUP] 8 [/SUP], Xiaohui Wu[SUP] 8 [/SUP]
Affiliations
- PMID: 33408630
- PMCID: PMC7779604
- DOI: 10.3389/fphar.2020.600592
Abstract
Background: D-dimer is a small protein fragment and high levels of D-dimer have been associated with increased mortality in patients presenting to emergency departments with infection. Previous studies have reported increased levels of D-dimer in COVID-19; however, it is unclear whether an increased D-dimer level provides early warning of poor prognosis. Therefore, this study aimed to assess the usefulness of D-dimer as an early indicator of prognosis in patients with coronavirus disease (COVID-19). Methods: We conducted a retrospective study of patients with COVID-19 admitted to Leishenshan Hospital in Wuhan, China, from February 15 to March 30, 2020. The final date of follow-up was April 11, 2020. Results: Of the 1,643 patients with COVID-19, 691 had elevated D-dimer levels. Their median age was 65 years. Of the patients with elevated D-dimer levels, 45% had comorbidities, with cardiovascular disease (205 [29.7%]) being the most common. Patients with elevated D-dimer were more likely to require treatment with high-flow oxygen, anticoagulation, antibiotics, and admission to the intensive care unit They were also more likely to have increased interleukin-6, monocytes, and lymphocytes. Patients with elevated D-dimer levels had significantly higher mortality than those with normal or low D-dimer levels. Conclusion: In patients with COVID-19, elevated D-dimer was associated with abnormal immunity, underlying disease, increased disease severity, and increased mortality. Taken together, D-dimer may be a marker for the early warning of disease severity and increased risk of death. These findings provide insights into the potential risk of elevated D-dimer in patients with COVID-19.
Keywords: COVID-19; SARS–CoV–2; critically ill patients; d-dimer; prognostic indicator.