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Association between D-Dimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic

M Sakka1, J M Connors2, G Hékimian3

  • 1Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Metabolic Biochemistry, 75013 Paris, France.

Journal De Medecine Vasculaire
|September 1, 2020
PubMed

Insights

Elevated D-dimer levels in hospitalized coronavirus disease 2019 (COVID-19) patients are significantly associated with increased mortality risk. Early D-dimer testing aids in risk stratification and management of COVID-19 patients.

Area of Science:

  • Biomedical research
  • Clinical diagnostics
  • Infectious disease epidemiology

Background:

  • Observational studies indicate elevated baseline D-dimer levels in moderate to severe COVID-19 patients.
  • These elevated levels correlate with disease severity and mortality in retrospective analyses.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis on the association between D-dimer levels and mortality in hospitalized COVID-19 patients.

Main Methods:

  • Systematic review of MEDLINE and EMBASE databases up to April 13, 2020.
  • Independent screening and data extraction by two authors.
  • Random effects model to estimate standardized mean difference (SMD) with 95% confidence intervals (CI).

Main Results:

  • Six studies with 1355 patients (391 non-survivors, 964 survivors) were included.
  • D-dimer levels were significantly higher in non-survivors (SMD 3.59μg/L, P<0.00001).
  • High heterogeneity (I²=95%) was observed across the included studies.

Conclusions:

  • D-dimer levels are significantly associated with mortality risk in COVID-19 patients, despite study heterogeneity.
  • Early integration of D-dimer testing can improve risk stratification and management.
  • D-dimer is a rapid, inexpensive, and accessible biomarker for COVID-19 patient assessment.
Abstract

Keywords:
Coronavirus disease 2019D-DimerMortalitySARS-CoV-2biomarker

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