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. 2022 Jan-Dec:28:10760296221079612.
doi: 10.1177/10760296221079612.

Predictive value of D-dimer in the clinical outcome of severe COVID19 patients: Are we giving it too much credit?

José P Cidade  1 , Luís Coelho  1   2 , Vasco Costa  1 , Rui Morais  1 , Patrícia Moniz  1 , Luís Morais  1 , Pedro Fidalgo  1 , António Tralhão  1 , Carolina Paulino  1 , David Nora  1 , Bernardino Valerio  1 , Vítor Mendes  1 , Camila Tapadinhas  1 , Pedro Póvoa  1   2   3
Affiliations

Predictive value of D-dimer in the clinical outcome of severe COVID19 patients: Are we giving it too much credit?

José P Cidade et al. Clin Appl Thromb Hemost. 2022 Jan-Dec.

Abstract

Background: COVID-19 is a new form of acute respiratory failure leading to multiorgan failure and ICU admission. Gathered evidence suggests that a 3-fold rise in D-dimer concentrations may be linked to poor prognosis and higher mortality.

Purpose: To describe D-dimer admission profile in severe ICU COVID19 patients and its predictive role in outcomes and mortality.

Methods: Single-center retrospective cohort study. All adult patients admitted to ICU with COVID19 were divided into 3 groups: (1) Lower-values group (D-dimer levels < 3-fold normal range value [NRV] [500ng/mL]), Intermediate-values group (D-dimer ≥3-fold and <10-fold NRV) and Higher-value group (≥10-fold NRV).

Results: 118 patients (mean age 63 years, 73% males) were included (N = 73 Lower-values group, N = 31 Intermediate-values group; N = 11 Higher-values group). Mortality was not different between groups (p = 0.51). Kaplan-Meier survival curves revealed no differences (p = 0.52) between groups, nor it was verified even when gender, age, ICU length of stay, and SOFA score were considered as covariables.

Conclusions: In severe COVID19 patients, the D-dimer profile does not retain a predictive value regarding patients' survivability and should not be used as a surrogate of disease severity.

Keywords: COVID19; D-dimer; critical care; mortality rate.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan-Meier Survival curves of Lower-values group, Intermediate-values group and Higher-values group.
Figure 2.
Figure 2.
ROC curves for prediction of 28-day mortality rate by d-dimer serum level at ICU admission and maximum d-dimer serum level registered.
See this image and copyright information in PMC

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