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Elevated Troponin, D-Dimers and D-Dimers/Fibrinogen Ratio Increase Mortality Risk in Remdesivir-Treated COVID-19

Georgia Ragia1,2, Gavriela Voulgaridou1,2, Vasileios Tsirozis3

  • 1Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece.

Journal of Personalized Medicine
|November 26, 2025
PubMed

Insights

Biomarkers like troponin and D-dimers predict mortality in COVID-19 patients treated with remdesivir. Remdesivir treatment impacts coagulation markers, potentially mitigating hypercoagulability and improving outcomes.

Area of Science:

  • Biochemistry
  • Critical Care Medicine
  • Pharmacology

Background:

  • Effective COVID-19 treatment requires monitoring biomarkers linked to severe illness and death.
  • Identifying prognostic markers is crucial for patient management.

Purpose of the Study:

  • To evaluate troponin, D-dimers, fibrinogen, and D-dimers/fibrinogen ratio (DFR) as mortality predictors in remdesivir-treated COVID-19 patients.
  • To assess remdesivir's impact on these biomarkers during treatment.

Main Methods:

  • Retrospective analysis of 549 hospitalized COVID-19 patients treated with remdesivir.
  • Evaluation of demographic, biochemical, and clinical data.
  • Statistical analysis of mortality risk and biomarker level changes.

Main Results:

  • Elevated baseline troponin and D-dimers increased mortality risk.
  • Post-remdesivir treatment, elevated troponin, D-dimers, and DFR remained associated with higher death risk.
  • Remdesivir decreased fibrinogen in both survivors and non-survivors.
  • Remdesivir decreased troponin and D-dimers in survivors but increased DFR and D-dimers in non-survivors.

Conclusions:

  • Troponin, D-dimers, and DFR are critical predictors of mortality in remdesivir-treated COVID-19 patients.
  • Remdesivir treatment influences coagulation biomarkers, potentially counteracting COVID-19-induced hypercoagulability.
  • These biomarkers can help identify high-risk patients for targeted interventions.

Keywords:
COVID-19D-dimersbiomarkersfibrinogenmortality risk factorsremdesivirtroponin

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