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. 2022 May 25;6(4):e12730.
doi: 10.1002/rth2.12730. eCollection 2022 May.

D-dimer testing in clinical practice in the era of COVID-19

Claire Auditeau  1 , Lina Khider  2   3   4 , Benjamin Planquette  2   3   5   6 , Olivier Sanchez  2   3   5   6 , David M Smadja  1   2   3   6 , Nicolas Gendron  1   2   3
Affiliations

D-dimer testing in clinical practice in the era of COVID-19

Claire Auditeau et al. Res Pract Thromb Haemost. .

Abstract

D-dimer is a fragment of crosslinked fibrin resulting from plasmin cleavage of fibrin clots and hence an indirect biomarker of the hemostatic system activation. Early in the coronavirus disease 2019 (COVID-19) pandemic, several studies described coagulation disorders in affected patients, including high D-dimer levels. Consequently, D-dimer has been widely used in not-yet-approved indications. Ruling out pulmonary embolism and deep vein thrombosis in patients with low or intermediate clinical suspicion is the main application of D-dimer. D-dimer is also used to estimate the risk of venous thromboembolism recurrence and is included in the ISTH algorithm for the diagnosis of disseminated intravascular coagulation. Finally, numerous studies identified high D-dimer levels as a biomarker of poor prognosis in hospitalized patients with COVID-19. This report focuses on validated applications of D-dimer testing in patients with and without COVID-19.

Keywords: COVID‐19; COVID‐19 vaccines; D‐dimer; anticoagulant; biomarker; disseminated intravascular coagulation; fibrin; fibrin fragment D; fibrinogen degradation products; predictive value of tests; prognosis; pulmonary embolism; venous thromboembolism.

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Figures

FIGURE 1
FIGURE 1
Summary of D‐dimer testing applications. COVID‐19, coronavirus disease 2019; DIC, disseminated intravascular coagulation; DVT, deep vein thrombosis; PE, pulmonary embolism; VTE, venous thromboembolism
See this image and copyright information in PMC

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