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D-dimer levels and COVID-19 severity: Systematic Review and Meta-Analysis
Muhammed Emin Düz1, Aydın Balcı2, Elif Menekşe1
1Department of Medical Biochemistry, Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya, Turkey.
Tuberkuloz Ve Toraks
|January 15, 2021
Summary
High D-dimer levels indicate increased severity in COVID-19 patients. This finding aids in early diagnosis and treatment strategies for severe coronavirus disease 2019.
Area of Science:
- Biomedical Science
- Infectious Diseases
- Hematology
Background:
- Coronavirus disease 2019 (COVID-19) presents challenges due to asymptomatic cases and long incubation periods.
- Elevated D-dimer levels have been suggested as potential predictors of COVID-19 severity, lung complications, and thromboembolic events.
Purpose of the Study:
- To systematically evaluate and synthesize existing evidence on the association between D-dimer concentrations and COVID-19 severity.
- To determine if D-dimer levels can serve as a reliable biomarker for identifying severe cases of COVID-19.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases.
- Keywords used included "D-dimer" combined with "coronavirus" or "COVID-19."
- Standardized Mean Differences (SMD) and forest plots were employed to analyze serum D-dimer concentrations in severe versus non-severe COVID-19 patients, with statistical significance set at p < 0.05.
Main Results:
- Pooled analysis revealed significantly higher D-dimer concentrations in severe COVID-19 patients compared to non-severe cases (SMD: 2.32 μg/mL; 95% CI, 0.72-3.92 μg/mL; p < 0.001).
- Further analysis comparing severe patients to the total COVID-19 patient cohort also showed significantly elevated D-dimer levels (SMD: 2.01 μg/mL; 95% CI, 0.25-3.77 μg/mL; p = 0.08).
Conclusions:
- The findings indicate a significant elevation in D-dimer levels among patients with severe COVID-19.
- While the exact mechanism remains unclear, elevated D-dimer may be a valuable indicator for early diagnosis and guiding initial treatment strategies in severe COVID-19 cases.
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