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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.

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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

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