Evaluation of D-dimer as a predictor of severity, degree of pulmonary involvement and mortality in patients with COVID-19

Authors

DOI:

https://doi.org/10.15448/1980-6108.2022.1.43281

Keywords:

COVID-19, D-dimer, Disease Severity, Pulmonary involvement, Mortality

Abstract

Objective: To verify D-dimer values to predict disease severity, degree of lung involvement and mortality in patients with COVID-19. 
Method: The D-dimer levels of 200 confirmed COVID-19 patients were prospectively measured in the Emergency Department of Razi Hospital of Ahvaz on the admission day, and its relations with the illness severity, computed tomography (CT) score, and mortality were assessed. 
Results: D-dimer level > 1.04 μg/mL and ≤ 1.12 μg/mL could indicate severe illness and high grade of pulmonary involvement but low risk of death. The mortality rate in the patients with D-dimer level > 1.12 μg/mL (was significantly higher than its rate in those with D-dimer level ≤ 1.12 μg/mL (17.2% x 1.5%; P:0.02). An independent positive correlation was found between D-dimer and Chest CT score as well as the disease severity (OR: 1.84; 95%CI:1.38 - 2.45; P:0.0001). 
Conclusion: D-dimer level > 1.12 μg/mL on the early stage of COVID-19 infection may independently predict the severe illness, high grade of pulmonary involvement, and high risk of death, indicating its beneficial role in timely management of critical patients.

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Author Biographies

Mofid Hosseinzadeh, Emergency Medicine Department, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran.

MD-PhD in Emergency medicine from Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; assistant professor at the Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Mandana Pouladzadeh, Emergency Medicine Department, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran.

MD-PhD in Emergency medicine from Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; assistant professor at the Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Amin Eftekhar, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.

Graduated MD student from Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Parastoo Moradi Choghakabodi, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.

DVM from Shahid Chamran University of Ahvaz (Jundi Shapur); MD Senior Clinical Investigator at Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Alireza Sokooti, Department of Pathology, Razi Hospital, School of Medicine, Ahvaz, Khuzestan, Iran.

MD-Phd of clinical pathology from Department of Pathology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; working at Razi Hospital

References

Kilercik M, Demirelce Ö, Serdar MA, Mikailova P, Serteser M. A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients. PLoS One. 2021;16(8):e0254073. https://doi.org/10.1371/journal.pone.0254073

Ding Y, Yan H, Guo W. Clinical Characteristics of Children With COVID-19: A Meta-Analysis. Front Pediatr. 2020;8:431. https://doi.org/10.3389/fped.2020.00431

Mitchell WB. Thromboinflammation in COVID-19 acute lung injury. Paediatr Respir Rev. 2020;35:20-4. https://doi.org/10.1016/j.prrv.2020.06.004

Rostami M, Mansouritorghabeh H. D-dimer level in COVID-19 infection: a systematic review. Expert Rev Hematol. 2020;13(11):1265-75. https://doi.org/10.1080/17474086.2020.1831383

Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z et al. D-dimer levels on admission to predict in-hospital mortality in patients with COVID-19. J Thromb Haemost. 2020;18(6):1324-29. https://doi.org/10.1111/jth.14859

Pouladzadeh M, Safdarian M, Choghakabodi PM, Amini F, Sokooti A. Validation of red cell distribution width as a COVID-19 severity screening tool. Future Sci OA. 2021;7(7);FSO712. https://doi.org/10.2144/fsoa-2020-0199

Mruk B, Plucińska D, Walecki J, Półtorak-Szymczak G, Sklinda K. Chest Computed Tomography (CT) Severity Scales in COVID-19 Disease: A Validation Study. Med Sci Monit. 202;27:e931283. https://doi.org/10.12659/MSM.931283

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. https://doi.org/10.1056/NEJMoa2002032

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi.org/10.1016/S0140-6736(20)30566-3

Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094-99. https://doi.org/10.1111/jth.14817

Gupta N, Zhao YY, Evans CE. The stimulation of thrombosis by hypoxia. Thromb Res. 2019;181:77-83. https://doi.org/10.1016/j.thromres.2019.07.013

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Published

2022-10-05

How to Cite

Hosseinzadeh, M., Pouladzadeh, M., Eftekhar, A., Choghakabodi, P. M., & Sokooti, A. (2022). Evaluation of D-dimer as a predictor of severity, degree of pulmonary involvement and mortality in patients with COVID-19. Scientia Medica, 32(1), e43281. https://doi.org/10.15448/1980-6108.2022.1.43281

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Vol. 32 No. 1 (2022): Single Volume

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