tetano
Editor, Senior Moderator
Front Public Health
. 2020 Aug 4;8:432.
doi: 10.3389/fpubh.2020.00432. eCollection 2020.
D-Dimer Concentrations and COVID-19 Severity: A Systematic Review and Meta-Analysis
Panagiotis Paliogiannis[SUP] 1 [/SUP], Arduino Aleksander Mangoni[SUP] 2 [/SUP], Paola Dettori[SUP] 3 [/SUP], Gheyath K Nasrallah[SUP] 4 5 [/SUP], Gianfranco Pintus[SUP] 6 7 [/SUP], Angelo Zinellu[SUP] 7 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) is a recently described infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since late 2019, COVID-19 has rapidly spread in virtually all countries, imposing the adoption of significant lockdown and social distancing measures. The activation of the coagulation cascade is a common feature of disseminated intravascular coagulation and adverse clinical outcomes in COVID-19 patients. In this study, we conducted a meta-analysis aiming to investigate differences in serum D-dimer concentrations in patients with and without severe COVID-19 disease. An electronic search in Medline (PubMed), Scopus and Web of Science was performed with no language restrictions, and 13 articles were reporting on 1,807 patients (585, 32.4% with severe disease) were finally identified and included in the meta-analysis. The pooled results of all studies revealed that the D-dimer concentrations were significantly higher in patients with more severe COVID-19 (SMD: 0.91 mg/L; 95% CI, 0.75 to 1.07 mg/L, p < 0.0001). The heterogeneity was moderate (I [SUP]2[/SUP] = 46.5%; p = 0.033). Sensitivity analysis showed that the effect size was not modified when any single study was in turn removed (effect size range, 0.87 mg/L to 0.93 mg/L). The Begg's (p = 0.76) and Egger's tests (p = 0.38) showed no publication bias. In conclusion, our systematic review and meta-analysis showed that serum D-dimer concentrations in patients with severe COVID-19 are significantly higher when compared to those with non-severe forms.
Keywords: COVID-19; D-dimer; SARS-CoV-2; coagulation; thrombosis.
. 2020 Aug 4;8:432.
doi: 10.3389/fpubh.2020.00432. eCollection 2020.
D-Dimer Concentrations and COVID-19 Severity: A Systematic Review and Meta-Analysis
Panagiotis Paliogiannis[SUP] 1 [/SUP], Arduino Aleksander Mangoni[SUP] 2 [/SUP], Paola Dettori[SUP] 3 [/SUP], Gheyath K Nasrallah[SUP] 4 5 [/SUP], Gianfranco Pintus[SUP] 6 7 [/SUP], Angelo Zinellu[SUP] 7 [/SUP]
Affiliations
- PMID: 32903841
- PMCID: PMC7438945
- DOI: 10.3389/fpubh.2020.00432
Abstract
Coronavirus disease 2019 (COVID-19) is a recently described infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since late 2019, COVID-19 has rapidly spread in virtually all countries, imposing the adoption of significant lockdown and social distancing measures. The activation of the coagulation cascade is a common feature of disseminated intravascular coagulation and adverse clinical outcomes in COVID-19 patients. In this study, we conducted a meta-analysis aiming to investigate differences in serum D-dimer concentrations in patients with and without severe COVID-19 disease. An electronic search in Medline (PubMed), Scopus and Web of Science was performed with no language restrictions, and 13 articles were reporting on 1,807 patients (585, 32.4% with severe disease) were finally identified and included in the meta-analysis. The pooled results of all studies revealed that the D-dimer concentrations were significantly higher in patients with more severe COVID-19 (SMD: 0.91 mg/L; 95% CI, 0.75 to 1.07 mg/L, p < 0.0001). The heterogeneity was moderate (I [SUP]2[/SUP] = 46.5%; p = 0.033). Sensitivity analysis showed that the effect size was not modified when any single study was in turn removed (effect size range, 0.87 mg/L to 0.93 mg/L). The Begg's (p = 0.76) and Egger's tests (p = 0.38) showed no publication bias. In conclusion, our systematic review and meta-analysis showed that serum D-dimer concentrations in patients with severe COVID-19 are significantly higher when compared to those with non-severe forms.
Keywords: COVID-19; D-dimer; SARS-CoV-2; coagulation; thrombosis.