Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Oct 28;16(10):e0258351.
doi: 10.1371/journal.pone.0258351. eCollection 2021.

Impact of persistent D-dimer elevation following recovery from COVID-19

Antje Lehmann  1 , Helmut Prosch  2 , Sonja Zehetmayer  3 , Maximilian Robert Gysan  1 , Dominik Bernitzky  1 , Karin Vonbank  1 , Marco Idzko  1 , Daniela Gompelmann  1
Affiliations
Multicenter Study

Impact of persistent D-dimer elevation following recovery from COVID-19

Antje Lehmann et al. PLoS One. .

Abstract

Background: Elevated D-dimer is known as predictor for severity of SARS-CoV2-infection. Increased D-dimer is associated with thromboembolic complications, but it is also a direct consequence of the acute lung injury seen in COVID-19 pneumonia.

Objectives: To evaluate the rate of persistent elevated D-dimer and its association with thromboembolic complications and persistent ground glass opacities (GGO) after recovery from COVID-19.

Methods: In this post hoc analysis of a prospective multicenter trial, patients underwent blood sampling, measurement of diffusion capacity, blood gas analysis, and multidetector computed tomography (MDCT) scan following COVID-19. In case of increased D-dimer (>0,5 μg/ml), an additional contrast medium-enhanced CT was performed in absence of contraindications. Results were compared between patients with persistent D-dimer elevation and patients with normal D-dimer level.

Results: 129 patients (median age 48.8 years; range 19-91 years) underwent D-Dimer assessment after a median (IQR) of 94 days (64-130) following COVID-19. D-dimer elevation was found in 15% (19/129) and was significantly more common in patients who had experienced a severe SARS-CoV2 infection that had required hospitalisation compared to patients with mild disease (p = 0.049). Contrast-medium CT (n = 15) revealed an acute pulmonary embolism in one patient and CTEPH in another patient. A significant lower mean pO2 (p = 0.015) and AaDO2 (p = 0.043) were observed in patients with persistent D-Dimer elevation, but the rate of GGO were similar in both patient groups (p = 0.33).

Conclusion: In 15% of the patients recovered from COVID-19, persistent D-dimer elevation was observed after a median of 3 months following COVID-19. These patients had experienced a more severe COVID and still presented more frequently a lower mean pO2 and AaDO2.

PubMed Disclaimer

Conflict of interest statement

NO authors have competing interests.

Figures

Fig 1
Fig 1. Computed tomography scan 3 months following SARS-CoV2 infection.
Bilateral ground-glass opacities and mild peripheral reticular pattern.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. 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):1054–1062. doi: 10.1016/S0140-6736(20)30566-3 - DOI - PMC - PubMed
    1. Shah S, Shah K, Patel SB, Patel FS, Osman M, Velagapudi P, et al.. Elevated D-Dimer Levels Are Associated With Increased Risk of Mortality in Coronavirus Disease 2019: A Systematic Review and Meta-Analysis. Cardiol Rev. 2020. Nov/Dec;28(6):295–302. doi: 10.1097/CRD.0000000000000330 - DOI - PMC - PubMed
    1. Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR Am J Roentgenol. 2020. May;214(5):1072–1077. doi: 10.2214/AJR.20.22976 - DOI - PubMed
    1. Liu H, Luo S, Zhang Y, Jiang Y, Jiang Y, Wang Y, et al.. Chest CT Features of 182 Patients with Mild Coronavirus Disease 2019 (COVID-19) Pneumonia: A Longitudinal, Retrospective and Descriptive Study. Infect Dis Ther. 2020. Dec;9(4):1029–1041. doi: 10.1007/s40121-020-00352-z - DOI - PMC - PubMed
    1. Zhu J, Chen C, Shi R, Li B. Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019. Pak J Med Sci. 2020. Sep-Oct;36(6):1397–1401. doi: 10.12669/pjms.36.6.2961 - DOI - PMC - PubMed

Publication types