Clinical Significance of Plasma D-Dimer in COVID-19 Mortality

Yayun, LI; Deng, Yuping; Ye, Lin; Sun, Huiyan; Du, Songtao; Huang, Huining; Zeng, Furong; Chen, Xiang; Deng, Guangtong

doi:10.3389/fmed.2021.638097

Cited by 25 publications

(30 citation statements)

References 95 publications

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“…The novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has become a major public health problem worldwide, leading to 5,551,314 deaths as of January 2022 [ 1 ]. Some major risk factors for developing severe COVID-19 include advanced age, increased body mass index (BMI), type 2 diabetes (T2D), and hypertension, among others [ 2 ]. Additionally, it has been reported that among individuals with worse COVID-19 outcomes, inefficient immune responses promote hyperinflammation, leading to a cytokine storm [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Ávila-Nava

Pech-Aguilar

Lugo

et al. 2022

Oxidative Medicine and Cellular Longevity

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Background. Activation of the immune system response is associated with the generation of oxidative stress (OS). Several alterations are involved in OS, such as excessive production of reactive oxygen species (ROS) and decreased antioxidant activity, which together lead to an imbalance in redox status. The role of OS during SARS-CoV-2 infection is not fully understood. The aim of this study was to determine OS biomarkers and assess their usefulness as a predictor of mortality in COVID-19 patients. Methods. Baseline characteristics and serum samples were collected from hospitalized COVID-19 patients and compared with healthy controls. The serum OS biomarkers, including malondialdehyde (MDA) and total antioxidant capacity (TAC), were assessed by spectrophotometric and oxygen radical absorbance capacity (ORAC) methods, respectively. Results. A total of 152 individuals were analyzed (COVID-19 patients vs. healthy controls). Compared with healthy controls ( n = 76 ), patients infected with SARS-CoV-2 ( n = 76 ) presented higher levels of MDA ( p < 0.001 ) and decreased TAC ( p < 0.001 ). A total of 37 (49%) patients with COVID-19 died. The area under the receiver operating characteristic (ROC) curve (AUC) estimated that the combination of the OS biomarkers (MDA+TAC) ( AUC = 0.6394 , p = 0.037 ) was a significant predictor of mortality. A higher level of MDA was associated with mortality (HR, 1.05, 95% CI, 1.00–1.10, p = 0.045 ). Conclusion. This study concludes that OS is increased in patients with COVID-19 and is associated with mortality. To our knowledge, this is the first evidence of the expression of OS biomarkers and their association with mortality among the Mexican population.

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Section: Introductionmentioning

confidence: 99%

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Ávila-Nava

Pech-Aguilar

Lugo

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…Hyperinflammation and hypoxia-induced injury caused by SARS-CoV-2 infection induced endothelial cell dysfunction and increased thrombosis and d -dimer [ 13 ]. Previous studies showed that d -dimer levels were associated with severity and outcomes in COVID-19 patients [ 5 , 11 , 14 , 15 , 16 ]. Zheng et al reported that thrombocytopenia, neutrophilia, and lymphocytopenia were independent biomarkers associated with outcomes in COVID-19 patients in a retrospective study, as shown in the present study [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…An excessive immune response against SARS-CoV-2 induced by inflammatory cytokines and chemokines (i.e., cytokine storm) can contribute to the development of critical respiratory failure due to ALI/ARDS [ 6 ]. Previous studies have shown that serum levels of certain biomarkers were associated with disease severity and outcomes [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Moreover, studies using prediction models (ISARIC4C and COVID-GRAM) reported that the areas under the curve (AUC) for predicting the outcome of COVID-19 patients, including mortality and/or ICU admission, were 0.774 and 0.706, respectively [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Early Biomarkers Associated with the Development of Critical Respiratory Failure in Coronavirus Disease 2019 (COVID-19)

et al. 2022

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Certain biomarkers predict death due to acute respiratory distress syndrome in COVID-19 patients. We retrospectively analyzed biomarkers associated with time to mechanical ventilation for respiratory failure due to COVID-19 (time-to-mechanical ventilation) in 135 consecutive patients in our hospital. We analyzed biomarkers that were elevated immediately (at admission) and later (3 days after admission) using Cox proportional hazards regression analysis. Independent biomarkers of time-to-mechanical ventilation were high C-reactive protein (CRP), interleukin (IL)-6, and Krebs von den Lungen-6 (KL-6) concentrations at admission and elevated CRP, high-mobility group box-1 protein (HMGB-1), and d-dimer levels and low platelets 3 days after admission. Receiver operating characteristic analysis for detecting the association between independent biomarkers associated with time-to-event in multivariate analyses and the start of mechanical ventilation revealed that these biomarkers had area under the curve values higher than 0.700. The present study suggests that CRP was the only biomarker associated with time-to-mechanical ventilation both at admission and 3 days after admission. Moreover, IL-6 (an inflammatory cytokine), HMGB-1 (a late inflammatory mediator), and KL-6 (reflecting injury and/or remodeling of type II pneumocytes) were associated with outcomes in COVID-19 as reported previously. In conclusion, increased CRP, IL-6, KL-6, HMGB-1, and d-dimer levels and decreased platelet counts were associated with the start of mechanical ventilation due to COVID-19.

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“…Therefore, vaccination status could not interfere with our results. Some studies and reviews analyzed the predictive value of only one or two parameters, and their usefulness in predicting outcomes of COVID-19, e.g., the role of platelet/lymphocyte ratio [28], HbA 1c [29], vitamin D3 levels [30], obesity [31], d-dimer [32], lymphocyte, or neutrophil count [33]. Other studies tried to provide predictors from a more complete set of clinical markers.…”

Section: Discussionmentioning

confidence: 99%

Plasma Levels and Renal Handling of Amino Acids Contribute to Determination of Risk of Mortality or Feed of Ventilation in Patients with COVID-19

et al. 2022

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COVID-19 infection may lead to serious complications, e.g., need for mechanical ventilation or death in some cases. A retrospective analysis of patients referred to our COVID Emergency Department, indiscriminately, was performed. A routine lab analysis measured amino acids in plasma and urine of patients. Data of surviving and deceased patients and those requiring or not requiring mechanical ventilation were compared, and logistic regression analyses have been performed. Deceased patients were older, had higher blood glucose, potassium, AST, LDH, troponin, d-dimer, hsCRP, procalcitonin, interleukin-6 levels (p < 0.05 for all). They had lower plasma serine, glycine, threonine, tryptophan levels (p < 0.01), higher tyrosine and phenylalanine levels (p < 0.05), and higher fractional excretion of arginine, methionine, and proline (p < 0.05) than survivors. In a regression model, age, severity score of COVID-pneumonia, plasma levels of threonine and phenylalanine were predictors of in-hospital mortality. There was a difference in ventilated vs. non-ventilated patients in CT-scores, glucose, and renal function (p < 0.001). Using logistic regression, CT-score, troponin, plasma level, and fractional excretion of glycine were predictors of ventilation. Plasma levels and renal excretion of certain amino acids are associated with the outcome of COVID-19 infection beside other parameters such as the CT-score or age.

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Clinical Significance of Plasma D-Dimer in COVID-19 Mortality

Cited by 25 publications

References 95 publications

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Analysis of Early Biomarkers Associated with the Development of Critical Respiratory Failure in Coronavirus Disease 2019 (COVID-19)

Plasma Levels and Renal Handling of Amino Acids Contribute to Determination of Risk of Mortality or Feed of Ventilation in Patients with COVID-19

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