tetano
Editor, Senior Moderator
J Med Vasc
. 2020 Sep;45(5):268-274.
doi: 10.1016/j.jdmv.2020.05.003. Epub 2020 May 27.
Association between D-Dimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and pooled analysis
M Sakka[SUP] 1 [/SUP], J M Connors[SUP] 2 [/SUP], G H?kimian[SUP] 3 [/SUP], I Martin-Toutain[SUP] 4 [/SUP], B Crichi[SUP] 5 [/SUP], I Colmegna[SUP] 6 [/SUP], D Bonnefont-Rousselot[SUP] 7 [/SUP], D Farge[SUP] 8 [/SUP], C Frere[SUP] 9 [/SUP]
Affiliations
Abstract
Background: Several observational studies have reported elevated baseline D-dimer levels in patients hospitalized for moderate to severe coronavirus disease 2019 (COVID-19). These elevated baseline D-dimer levels have been associated with disease severity and mortality in retrospective cohorts.
Objectives: To review current available data on the association between D-Dimer levels and mortality in patients admitted to hospital for COVID-19.
Methods: We performed a systematic review of published studies using MEDLINE and EMBASE through 13 April 2020. Two authors independently screened all records and extracted the outcomes. A random effects model was used to estimate the standardized mean difference (SMD) with 95% confidence intervals (CI).
Results: Six original studies enrolling 1355 hospitalized patients with moderate to critical COVID-19 (391 in the non-survivor group and 964 in the survivor group) were considered for the final pooled analysis. When pooling together the results of these studies, D-Dimer levels were found to be higher in non-survivors than in-survivors. The SMD in D-Dimer levels between non-survivors and survivors was 3.59μg/L (95% CI 2.79-4.40μg/L), and the Z-score for overall effect was 8.74 (P<0.00001), with a high heterogeneity across studies (I[SUP]2[/SUP]=95%).
Conclusions: Despite high heterogeneity across included studies, the present pooled analysis indicates that D-Dimer levels are significantly associated with the risk of mortality in COVID-19 patients. Early integration of D-Dimer testing, which is a rapid, inexpensive, and easily accessible biological test, can be useful to better risk stratification and management of COVID-19 patients.
Keywords: Coronavirus disease 2019; D-Dimer; Mortality; SARS-CoV-2; biomarker.
. 2020 Sep;45(5):268-274.
doi: 10.1016/j.jdmv.2020.05.003. Epub 2020 May 27.
Association between D-Dimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and pooled analysis
M Sakka[SUP] 1 [/SUP], J M Connors[SUP] 2 [/SUP], G H?kimian[SUP] 3 [/SUP], I Martin-Toutain[SUP] 4 [/SUP], B Crichi[SUP] 5 [/SUP], I Colmegna[SUP] 6 [/SUP], D Bonnefont-Rousselot[SUP] 7 [/SUP], D Farge[SUP] 8 [/SUP], C Frere[SUP] 9 [/SUP]
Affiliations
- PMID: 32862984
- DOI: 10.1016/j.jdmv.2020.05.003
Abstract
Background: Several observational studies have reported elevated baseline D-dimer levels in patients hospitalized for moderate to severe coronavirus disease 2019 (COVID-19). These elevated baseline D-dimer levels have been associated with disease severity and mortality in retrospective cohorts.
Objectives: To review current available data on the association between D-Dimer levels and mortality in patients admitted to hospital for COVID-19.
Methods: We performed a systematic review of published studies using MEDLINE and EMBASE through 13 April 2020. Two authors independently screened all records and extracted the outcomes. A random effects model was used to estimate the standardized mean difference (SMD) with 95% confidence intervals (CI).
Results: Six original studies enrolling 1355 hospitalized patients with moderate to critical COVID-19 (391 in the non-survivor group and 964 in the survivor group) were considered for the final pooled analysis. When pooling together the results of these studies, D-Dimer levels were found to be higher in non-survivors than in-survivors. The SMD in D-Dimer levels between non-survivors and survivors was 3.59μg/L (95% CI 2.79-4.40μg/L), and the Z-score for overall effect was 8.74 (P<0.00001), with a high heterogeneity across studies (I[SUP]2[/SUP]=95%).
Conclusions: Despite high heterogeneity across included studies, the present pooled analysis indicates that D-Dimer levels are significantly associated with the risk of mortality in COVID-19 patients. Early integration of D-Dimer testing, which is a rapid, inexpensive, and easily accessible biological test, can be useful to better risk stratification and management of COVID-19 patients.
Keywords: Coronavirus disease 2019; D-Dimer; Mortality; SARS-CoV-2; biomarker.