Related Experiment Video
Updated: Dec 14, 2025
Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease
Published on: July 3, 2018
D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study
Yumeng Yao1, Jiatian Cao2, Qingqing Wang1
1Department of Infectious Diseases, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, 200032 China.
Insights
Elevated D-dimer levels in COVID-19 patients are linked to increased mortality risk. D-dimer serves as a reliable biomarker for predicting disease severity and clinical outcomes in hospitalized coronavirus disease-19 patients.
Area of Science:
- Biochemistry
- Clinical Medicine
- Epidemiology
Background:
- Coronavirus disease-19 (COVID-19) has caused millions of cases globally since December 2019.
- Identifying risk factors for COVID-19 mortality is crucial for patient management.
- D-dimer is being investigated as a potential biomarker for COVID-19 severity and outcomes.
Purpose of the Study:
- To explore risk factors associated with mortality in COVID-19 patients.
- To assess the utility of D-dimer as a biomarker for disease severity and clinical outcomes.
- To determine the prognostic value of D-dimer levels for in-hospital mortality in COVID-19 patients.
Main Methods:
- Retrospective analysis of 248 COVID-19 patients' clinical, laboratory, and radiological data.
- Univariable and multivariable logistic regression to identify mortality risk factors.
- Correlation analysis and ROC curve to evaluate D-dimer's association with severity and mortality.
Main Results:
- D-dimer > 2.0 mg/L at admission was the sole predictor of increased mortality risk (OR 10.17, P=0.041).
- D-dimer levels significantly correlated with increasing COVID-19 severity (clinical and CT staging).
- A D-dimer level > 2.14 mg/L predicted in-hospital mortality with 88.2% sensitivity and 71.3% specificity (AUC 0.85).
Conclusions:
- D-dimer is frequently elevated in COVID-19 patients.
- D-dimer levels correlate with COVID-19 disease severity.
- D-dimer is a reliable prognostic marker for in-hospital mortality in COVID-19 patients.
Background:
Over 5,488,000 cases of coronavirus disease-19 (COVID-19) have been reported since December 2019. We aim to explore risk factors associated with mortality in COVID-19 patients and assess the use of D-dimer as a biomarker for disease severity and clinical outcome.
Methods:
We retrospectively analyzed the clinical, laboratory, and radiological characteristics of 248 consecutive cases of COVID-19 in Renmin Hospital of Wuhan University, Wuhan, China from January 28 to March 08, 2020. Univariable and multivariable logistic regression methods were used to explore risk factors associated with in-hospital mortality. Correlations of D-dimer upon admission with disease severity and in-hospital mortality were analyzed. Receiver operating characteristic curve was used to determine the optimal cutoff level for D-dimer that discriminated those survivors versus non-survivors during hospitalization.
Results:
Multivariable regression that showed D-dimer > 2.0 mg/L at admission was the only variable associated with increased odds of mortality [OR 10.17 (95% CI 1.10-94.38), P = 0.041]. D-dimer elevation (≥ 0.50 mg/L) was seen in 74.6% (185/248) of the patients. Pulmonary embolism and deep vein thrombosis were ruled out in patients with high probability of thrombosis. D-dimer levels significantly increased with increasing severity of COVID-19 as determined by clinical staging (Kendall's tau-b = 0.374, P = 0.000) and chest CT staging (Kendall's tau-b = 0.378, P = 0.000). In-hospital mortality rate was 6.9%. Median D-dimer level in non-survivors (n = 17) was significantly higher than in survivors (n = 231) [6.21 (3.79-16.01) mg/L versus 1.02 (0.47-2.66) mg/L, P = 0.000]. D-dimer level of > 2.14 mg/L predicted in-hospital mortality with a sensitivity of 88.2% and specificity of 71.3% (AUC 0.85; 95% CI = 0.77-0.92).
Conclusions:
D-dimer is commonly elevated in patients with COVID-19. D-dimer levels correlate with disease severity and are a reliable prognostic marker for in-hospital mortality in patients admitted for COVID-19.
Related Concept Videos
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:30Acute Coronary Syndrome III: Diagnostic Studies