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D-dimer: old dogmas, new (COVID-19) tricks.

Giuseppe Lippi1, François Mullier2, Emmanuel J Favaloro3,4,5

  • 1Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy.

Clinical Chemistry and Laboratory Medicine
|July 18, 2022
PubMed
Summary

D-dimer testing is crucial for diagnosing blood clots like venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC). Elevated D-dimer levels also indicate severity in COVID-19 patients and may predict complications after vaccination.

Keywords:
COVID-19D-dimerSARS-CoV-2thrombosisvenous thromboembolism

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Area of Science:

  • Biochemistry
  • Hematology
  • Clinical Diagnostics

Background:

  • D-dimer is a fibrin degradation product formed during hemostasis and fibrinolysis.
  • D-dimer assays are integral to diagnosing and prognosing venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC).

Purpose of the Study:

  • To explore the expanding clinical applications of D-dimer testing.
  • To evaluate the role of D-dimer in coronavirus disease 2019 (COVID-19) management and post-vaccination complications.

Main Methods:

  • Review of current literature and clinical findings regarding D-dimer utility.
  • Analysis of D-dimer levels in relation to VTE, DIC, COVID-19 severity, and vaccine-induced immune thrombotic thrombocytopenia (VITT).

Main Results:

  • D-dimer aids in VTE/DIC diagnosis and prognosis, especially with age-adjusted thresholds.
  • Elevated D-dimer in COVID-19 correlates with disease severity, mortality, and post-discharge sequelae.
  • D-dimer monitoring may guide anticoagulant therapy in severe COVID-19 and identify VITT risk post-vaccination.

Conclusions:

  • D-dimer's diagnostic and prognostic value extends beyond traditional thrombotic diseases.
  • D-dimer plays a significant role in managing COVID-19 patients and assessing risks associated with SARS-CoV-2 infection and vaccination.