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Elevated levels of D-dimer in patients with COVID-19: prognosis value

Sara Oualim1, Salma Abdeladim1, Amal El Ouarradi1

  • 1Department of cardiology, Cheick Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.

The Pan African Medical Journal
|December 7, 2020
PubMed

Insights

Elevated D-dimer levels in COVID-19 patients can predict poor outcomes. A D-dimer level above 1360 ng/ml on day 5 indicates a higher risk of in-hospital mortality.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Hematology

Background:

  • Coronavirus disease (COVID-19) is a global pandemic with significant respiratory, cardiovascular, and neurological impacts.
  • Rapid human-to-human transmission necessitates effective prognostic markers for COVID-19 progression.
  • Elevated D-dimer levels are investigated as potential indicators of severe COVID-19 outcomes.

Purpose of the Study:

  • To determine if elevated D-dimer levels predict poor progression of COVID-19.
  • To assess the prognostic value of D-dimer levels for reducing COVID-19 mortality.
  • To identify optimal D-dimer cutoff values for predicting in-hospital mortality.

Main Methods:

  • Retrieved data from 89 COVID-19 patients treated between March 21 and April 24, 2020.
  • Utilized Receiver Operating Characteristic (ROC) curves to establish D-dimer cutoff values on admission and day 5.
  • Compared in-hospital mortality rates between patient groups stratified by D-dimer levels.

Main Results:

  • An admission D-dimer cutoff of 668 ng/ml predicted mortality with 90% sensitivity and 63.3% specificity (AUC 0.775).
  • A day 5 D-dimer cutoff of 1360 ng/ml predicted mortality with 100% sensitivity and 88.6% specificity (AUC 0.946).
  • Patients with day 5 D-dimer > 1360 ng/ml (19 patients) exhibited worse outcomes and significantly higher mortality (10/19) compared to those with levels < 1360 ng/ml (0/69, P = 0.0002).

Conclusions:

  • D-dimer levels exceeding 1360 ng/ml on day 5 are a strong predictor of poor prognosis in COVID-19 patients.
  • This finding aids clinicians in early identification of high-risk individuals.
  • Early identification facilitates timely interventions to potentially reduce COVID-19 mortality.
Abstract

Keywords:
Coronavirus diseaseD-dimermortalityprognosis

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