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Study to Determine a Prognostic Cutoff Values of the Coagulation Analyte D-dimer for ICU Admission among COVID-19

Mary Chandrika Anton1, B Shanthi2, E Vasudevan2

  • 1Department of Biochemistry, Bhaarath Medical College and Hospital and Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|March 3, 2023
PubMed

Insights

A D-dimer level of 1036.9 ng/mL can predict intensive care unit (ICU) admission for coronavirus disease-2019 (COVID-19) patients. This cutoff value demonstrates high sensitivity for identifying severe COVID-19 cases requiring critical care.

Area of Science:

  • Medical Research
  • Critical Care Medicine
  • Hematology

Background:

  • Coronavirus disease-2019 (COVID-19) is associated with coagulopathy and varying severity.
  • Existing D-dimer measurements lack specific cutoffs to predict disease progression or severity in COVID-19 patients.

Purpose of the Study:

  • To establish prognostic cutoff values for D-dimer to predict intensive care unit (ICU) admission in COVID-19 patients.

Main Methods:

  • A cross-sectional study was conducted with 460 COVID-19-positive individuals.
  • D-dimer levels were measured and analyzed in relation to disease severity and ICU admission.

Main Results:

  • Mean D-dimer levels varied significantly with illness severity: mild (461.8 ± 221 ng/mL), moderate (1915.2 ± 699.9 ng/mL), and severe (7937.6 ± 2045.2 ng/mL).
  • A D-dimer cutoff value of 1036.9 ng/mL was identified as a prognostic indicator for ICU admission.
  • This cutoff demonstrated excellent predictive performance with 99% sensitivity and an AUC of 0.827 (p < 0.0001).

Conclusions:

  • The D-dimer value of 1036.9 ng/mL serves as an optimal cutoff for predicting the severity of COVID-19 and the need for ICU admission.
  • This finding aids in early identification of high-risk COVID-19 patients requiring intensive care.
Abstract

Keywords:
Coronavirus disease-2019D-dimerIntensive care unitPrognosisPrognostic cutoff

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