tetano
Editor, Senior Moderator
Heart Lung
. 2020 Sep 18;S0147-9563(20)30380-0.
doi: 10.1016/j.hrtlng.2020.08.024. Online ahead of print.
The association of D-dimers with mortality, intensive care unit admission or acute respiratory distress syndrome in patients hospitalized with coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis
Agam Bansal[SUP] 1 [/SUP], Achintya D Singh[SUP] 2 [/SUP], Vardhmaan Jain[SUP] 2 [/SUP], Manik Aggarwal[SUP] 3 [/SUP], Samiksha Gupta[SUP] 4 [/SUP], Rana Prathap Padappayil[SUP] 5 [/SUP], Mahum Nadeem[SUP] 6 [/SUP], Sonya Joshi[SUP] 7 [/SUP], Agrima Mian[SUP] 8 [/SUP], Tyler Greathouse[SUP] 9 [/SUP], David Wells[SUP] 10 [/SUP], Mohak Gupta[SUP] 11 [/SUP], Muhammad Zarrar Khan[SUP] 2 [/SUP]
Affiliations
Abstract
Aim: To determine if D-dimers are elevated in individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who have adverse clinical outcomes including all-cause mortality, intensive care unit (ICU) admission or acute respiratory distress syndrome (ARDS).
Methods: We conducted a systematic review and meta-analysis of the published literature in PubMed, Embase and Cochrane databases through April 9, 2020 for studies evaluating D-dimer levels in SARS-COV-2 infected patients with and without a composite clinical endpoint, defined as the presence of all-cause of mortality, Intensive care unit (ICU) admission or acute respiratory distress syndrome (ARDS). A total of six studies were included in the meta-analysis.
Results: D-dimers were significantly increased in patients with the composite clinical end point than in those without (SMD, 1.67 ug/ml (95% CI, 0.72-2.62 ug/ml). The SMD of the studies (Tang et al, Zhou et al, Chen et al), which used only mortality as an outcome measure was 2.5 ug/mL (95% CI, 0.62-4.41 ug/ml).
Conclusion: We conclude that SARS-CoV-2 infected patients with elevated D-dimers have worse clinical outcomes (all-cause mortality, ICU admission or ARDS) and thus measurement of D-dimers can guide in clinical decision making.
Keywords: ARDS; All-cause mortality; D-dimer; ICU admission; SARS-CoV-2.
. 2020 Sep 18;S0147-9563(20)30380-0.
doi: 10.1016/j.hrtlng.2020.08.024. Online ahead of print.
The association of D-dimers with mortality, intensive care unit admission or acute respiratory distress syndrome in patients hospitalized with coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis
Agam Bansal[SUP] 1 [/SUP], Achintya D Singh[SUP] 2 [/SUP], Vardhmaan Jain[SUP] 2 [/SUP], Manik Aggarwal[SUP] 3 [/SUP], Samiksha Gupta[SUP] 4 [/SUP], Rana Prathap Padappayil[SUP] 5 [/SUP], Mahum Nadeem[SUP] 6 [/SUP], Sonya Joshi[SUP] 7 [/SUP], Agrima Mian[SUP] 8 [/SUP], Tyler Greathouse[SUP] 9 [/SUP], David Wells[SUP] 10 [/SUP], Mohak Gupta[SUP] 11 [/SUP], Muhammad Zarrar Khan[SUP] 2 [/SUP]
Affiliations
- PMID: 33041057
- DOI: 10.1016/j.hrtlng.2020.08.024
Abstract
Aim: To determine if D-dimers are elevated in individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who have adverse clinical outcomes including all-cause mortality, intensive care unit (ICU) admission or acute respiratory distress syndrome (ARDS).
Methods: We conducted a systematic review and meta-analysis of the published literature in PubMed, Embase and Cochrane databases through April 9, 2020 for studies evaluating D-dimer levels in SARS-COV-2 infected patients with and without a composite clinical endpoint, defined as the presence of all-cause of mortality, Intensive care unit (ICU) admission or acute respiratory distress syndrome (ARDS). A total of six studies were included in the meta-analysis.
Results: D-dimers were significantly increased in patients with the composite clinical end point than in those without (SMD, 1.67 ug/ml (95% CI, 0.72-2.62 ug/ml). The SMD of the studies (Tang et al, Zhou et al, Chen et al), which used only mortality as an outcome measure was 2.5 ug/mL (95% CI, 0.62-4.41 ug/ml).
Conclusion: We conclude that SARS-CoV-2 infected patients with elevated D-dimers have worse clinical outcomes (all-cause mortality, ICU admission or ARDS) and thus measurement of D-dimers can guide in clinical decision making.
Keywords: ARDS; All-cause mortality; D-dimer; ICU admission; SARS-CoV-2.