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Role of peak D-dimer in predicting mortality and venous thromboembolism in COVID-19 patients

Rachel H Lee1, Shan Wang1,2, Meredith Akerman2,3

  • 1Department of Pharmacy, NYU Langone Hospital-Long Island, Mineola, NY, USA.

Science Progress
|February 27, 2025
PubMed

Insights

Elevated D-dimer levels in COVID-19 patients indicate higher risk for mortality and venous thromboembolism (VTE) events. This finding aids in predicting adverse outcomes for hospitalized patients.

Area of Science:

  • Medical research
  • Hematology
  • Infectious diseases

Background:

  • COVID-19 is frequently associated with elevated D-dimer levels.
  • Understanding the prognostic value of D-dimer is crucial for managing severe cases.

Purpose of the Study:

  • To evaluate the predictive role of D-dimer levels for mortality and venous thromboembolism (VTE) in hospitalized COVID-19 patients.

Main Methods:

  • Retrospective chart review of 350 COVID-19 patients from April to June 2020.
  • Analysis of peak D-dimer levels and correlation with mortality and VTE events (deep venous thrombosis, pulmonary embolism).

Main Results:

  • Patients with VTE events had significantly higher peak D-dimer levels (4876 ng/ml) compared to the non-VTE group (680 ng/ml).
  • Deceased patients exhibited higher peak D-dimer levels (4690 ng/ml) than survivors (501 ng/ml).
  • Optimal D-dimer cutoffs identified: 1437 ng/ml for VTE prediction (84.2% sensitivity, 65.0% specificity) and 2004 ng/ml for mortality prediction (71.0% sensitivity, 77.9% specificity).

Conclusions:

  • Elevated D-dimer levels in hospitalized COVID-19 patients are significant indicators of mortality risk.
  • D-dimer levels can serve as a valuable biomarker for predicting venous thromboembolism events in COVID-19 patients.

Keywords:
COVID19D-dimercoagulopathyvenous thromboembolism

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