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Course of COVID-19 Based on Admission D-Dimer Levels and Its Influence on Thrombosis and Mortality

Vaasanthi Rajendran1, Sowmya Gopalan1, Priyadarshini Varadaraj1

  • 1Department of General Medicine, Sri Ramachandra Medical College and Research Institute (SRMC&RI), Porur, Chennai 600116, India.

Journal of Clinical Medicine Research
|August 16, 2021
PubMed

Insights

Elevated D-dimer levels in COVID-19 patients strongly predict death but not thrombosis. Anticoagulation doses should not solely rely on absolute D-dimer measurements.

Area of Science:

  • Medical research
  • Infectious diseases
  • Cardiovascular medicine

Background:

  • Arterial and venous thrombosis are significant complications of coronavirus disease 2019 (COVID-19).
  • Previous studies have not compared D-dimer levels between COVID-19 patients with and without thrombosis.

Purpose of the Study:

  • To investigate the relationship between D-dimer levels and the occurrence of thrombosis in hospitalized COVID-19 patients.
  • To determine if D-dimer levels can predict thrombosis or death in COVID-19 patients.

Main Methods:

  • Retrospective analysis of D-dimer levels in 720 hospitalized COVID-19 patients from May to September 2020.
  • Patients categorized into three groups based on D-dimer elevation: normal (<0.5 µg/mL), up to six-fold elevation, and >six-fold elevation.
  • Statistical analysis using SPSS software to compare D-dimer levels and assess odds of thrombosis and death.

Main Results:

  • Eight thrombotic events were observed (1.1% incidence), including stroke, myocardial infarction, and mesenteric artery thrombosis.
  • No significant difference in median D-dimer levels was found between patients with and without thrombosis (1.34 vs. 0.91, P=0.11).
  • A >six-fold D-dimer elevation significantly increased the odds of death (adjusted odds ratio: 128.4, P<0.001) but not clinical thrombosis (adjusted odds ratio: 1.96, P=0.18).

Conclusions:

  • A six-fold elevation in D-dimer is a strong predictor of mortality in COVID-19 patients.
  • D-dimer levels alone are not a reliable predictor for developing thrombosis in COVID-19.
  • Anticoagulation therapy decisions should not be based solely on absolute D-dimer levels.
Abstract

Keywords:
COVID-19D-dimerDeath, AnticoagulationThrombosis

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