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D-dimer levels for Risk Stratification in Patients with Suspected COVID-19 - A Prospective Observational Study

A S Jauslin1, J Kellett2, M Brabrand3

  • 1MD, Emergency Department, University Hospital Basel, 4031 Basel, Switzerland.

Acute Medicine
|October 22, 2021
PubMed

Insights

Elevated D-dimer levels are strong predictors of 30-day mortality in patients with suspected or confirmed COVID-19. This finding holds true for both infected and non-infected individuals, highlighting D-dimer

Area of Science:

  • Clinical Medicine
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Elevated D-dimer levels are recognized in COVID-19 patients and possess prognostic value.
  • Previous studies lacked comparison with an appropriate control group for D-dimer's prognostic significance.

Purpose of the Study:

  • To investigate the prognostic value of D-dimer levels in emergency patients with suspected or confirmed COVID-19.
  • To compare the association of D-dimer levels with 30-day mortality in COVID-19 positive versus negative patients.

Main Methods:

  • An observational cohort study was conducted on 953 emergency patients.
  • Logistic regression analysis was employed to assess the association of D-dimer levels, COVID-19 status, age, and gender with 30-day mortality.

Main Results:

  • Overall, 56% of patients presented with elevated D-dimer levels (≥0.5mg/l).
  • Age (OR 1.07), D-dimer levels ≥0.5mg/l (OR 2.44), and COVID-19 positivity (OR 2.79) were significantly associated with 30-day mortality.
  • The 30-day mortality rate was 7.4% in confirmed COVID-19 patients and 3.5% in those without SARS-CoV-2 infection.

Conclusions:

  • D-dimer levels are effective prognostic indicators for 30-day mortality in emergency patients.
  • The prognostic value of D-dimer extends to both COVID-19 positive and negative patient cohorts.
Abstract

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