D-dimer level in COVID-19 infection: a systematic review

Rostami, Mehrdad; Mansouritorghabeh, Hassan

doi:10.1080/17474086.2020.1831383

Cited by 303 publications

(281 citation statements)

References 73 publications

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“…Other biomarkers, such as cardiac troponin, C-reactive protein, ferritin, fibrinogen, prothrombin time, and Ddimer were shown to be associated with a higher risk of mortality among critically ill COVID-19 patients in our study. These biomarkers have been reported in several studies and metaanalyses regarding their role as risk factors and factors predicting mortality and worsening of COVID-19 severity [47][48][49][50][51][52][53].…”

Section: Plos Onementioning

confidence: 89%

Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study

et al. 2021

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Background The coronavirus disease (COVID-19) pandemic has severely affected African countries, specifically the countries, such as Libya, that are in constant conflict. Clinical and laboratory information, including mortality and associated risk factors in relation to hospital settings and available resources, about critically ill patients with COVID-19 in Africa is not available. This study aimed to determine the mortality and morbidity of COVID-19 patients in intensive care units (ICU) following 60 days after ICU admission, and explore the factors that influence in‐ICU mortality rate. Methods This is a multicenter prospective observational study among COVID-19 critical care patients in 11 ICUs in Libya from May 29th to December 30th 2020. Basic demographic data, clinical characteristics, laboratory values, admission Sequential Organ Failure Assessment (SOFA) score, quick SOFA, and clinical management were analyzed. Result We included 465 consecutive COVID-19 critically ill patients. The majority (67.1%) of the patients were older than 60 years, with a median (IQR) age of 69 (56.5–75); 240 (51.6%) were male. At 60 days of follow-up, 184 (39.6%) were discharged alive, while 281 (60.4%) died in the intensive care unit. The median (IQR) ICU length of stay was 7 days (4–10) and non-survivors had significantly shorter stay, 6 (3–10) days. The body mass index was 27.9 (24.1–31.6) kg/m2. At admission to the intensive care unit, quick SOFA median (IQR) score was 1 (1–2), whereas total SOFA score was 6 (4–7). In univariate analysis, the following parameters were significantly associated with increased/decreased hazard of mortality: increased age, BMI, white cell count, neutrophils, procalcitonin, cardiac troponin, C-reactive protein, ferritin, fibrinogen, prothrombin, and d-dimer levels were associated with higher risk of mortality. Decreased lymphocytes, and platelet count were associated with higher risk of mortality. Quick SOFA and total SOFA scores increase, emergency intubation, inotrope use, stress myocardiopathy, acute kidney injury, arrythmia, and seizure were associated with higher mortality. Conclusion Our study reported the highest mortality rate (60.4%) among critically ill patients with COVID-19 60 days post-ICU admission. Several factors were found to be predictive of mortality, which may help to identify patients at risk of mortality during the ongoing COVID-19 pandemic.

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Section: Plos Onementioning

confidence: 89%

Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study

et al. 2021

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“…Three to four-fold increase of D-dimer levels was detected in the early stages of COVID-19 patients, which was associated with poor prognosis of COVID-19 patients [23]. Measuring the level of D-dimer and coagulation parameters from the early stage can also be useful in controlling and managing of COVID-19 disease [23]. Our data also showed that brinogen was elevated in the COVID-19 group, which suggested an activation of coagulation in the patients.…”

Section: Discussionmentioning

confidence: 93%

“…Studies had reported that COVID-19 patients had increased D-dimer and brin/ brinogen degradation products, while abnormalities in prothrombin time, partial thromboplastin time, and platelet counts were relatively rare [22,23]. Three to four-fold increase of D-dimer levels was detected in the early stages of COVID-19 patients, which was associated with poor prognosis of COVID-19 patients [23]. Measuring the level of D-dimer and coagulation parameters from the early stage can also be useful in controlling and managing of COVID-19 disease [23].…”

Section: Discussionmentioning

confidence: 99%

Comparative study of hematological and radiological feature of severe/critically ill patients with COVID-19, Influenza A H7N9 and H1N1 pneumonia

Kong

Wan²,

Shi

et al. 2020

Preprint

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Objectives This study aimed to explore useful clinical indexes for management of severe/critically ill patients with COVID-19, Influenza A H7N9 and H1N1 pneumonia by comparing hematological and radiological characteristics between them. Methods Severe/critically ill patients with confirmed diagnosis of COVID-19, Influenza A H7N9 and H1N1 pneumonia were retrospectively enrolled. The demographic data, clinical manifestations, hematological parameters, and radiological characteristics of three groups were compared. The influenza A was divided into two groups with/without patient death. Results In this study, 16 cases of COVID-19, 10 cases of influenza A (H7N9), and 13 cases of influenza A (H1N1) who met severe/critically ill criteria were included. Compared with COVID-19, the Influenza A (H7N9 and H1N1) groups had relatively more chronic diseases (80% and 92.3% vs 25%, P༜0.05), higher APACHE Ⅱ scores (16.00 ± 8.63 and 15.08 ± 6.24, vs 5.50 ± 2.58, P༜0.05) and higher mortality rates (40% and 46.2% vs 0%, P༜0.05). The hematological finding indicated that Influenza A H7N9 and H1N1 patients had more significant lymphocytopenia (0.59 ± 0.31 × 109/L and 0.56 ± 0.35 × 109/L vs 0.97 ± 0.33 × 109/L, P < 0.05), elevated neutrophil to lymphocyte ratio (NLR; 14.67 ± 6.10 and 14.64 ± 10.36 vs 6.29 ± 3.72, P < 0.05) compared to COVID-19. Especially in influenza A patients, NLR was significant different between the patients with or without death. Compared with the H7N9 group, ground glass opacity (GGO) on chest CT was more common in the COVID-19 group (P = 0.028), while pleural effusion was relatively rare (P = 0.001). Conclusion Compared to COVID-19, patients with Influenza A (H7N9 and H1N1) had more underlying chronic diseases and higher mortality rates. The NLR can be used as a clinical parameter for the predication of risk stratification and outcome in COVID-19 and Influenza A pneumonia. Manifestations of pleural effusion or GGO in chest CT may be helpful for the identification of different viral pneumonia.

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“…D-dimer values are even higher in patients with severe COVID-19 than in those with milder forms and therefore, D-dimer measurement may be associated with evolution toward worse clinical picture in COVID-19 patients. [26][27][28][29][30] Notably, Tang et al also recently highlighted that the vast majority of COVID-19 patients who died during hospital stay fulfilled the criteria for diagnosing disseminated intravascular coagulation (71.6 versus 0.6% in survivors). In the present study mean D-dimer values reduced significanctly in all subjects at the end of therapy (EOT) and it was statistically significant.…”

Section: Discussionmentioning

confidence: 99%

A prospective, open label clinical study to evaluate the safety, efficacy and tolerability of azadvir herbal steam inhaler in asymptomatic, mildly symptomatic COVID-19 patients and health care workers posted to covid wards

Pottirayil¹,

Shankar

Kannoth³

et al. 2021

Int J Basic Clin Pharmacol

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Background: COVID-19 patients experience cytokine storm which cause pulmonary and extra-pulmonary complications even with currently available of standard of care. Additional antiviral and immune boosters are the need of hour to treat COVID-19 and to prevent post covid complications.Methods: In this study we enrolled 40 asymptomatic to mild COVID-19 patients to receive azadvir herbal steam inhaler along with standard of care. We evaluated the benefits of azadvir herbal steam inhaler by assessing RT-PCR conversion, clinical outcomes and improvement in immune markers (LDH, CRP, D-DIMER).Results: At the end of the study the immune markers improved significantly in study patients. In mild symptomatic cases IL-6 was 23.2 pg/ml on day 0 and 21.8 pg/ml on day 14. Reduction in IL-6 in mild symptomatic patients was statistically highly significant (p=0.0056). Mean IL-6 in asymptomatic patients was 22.3 pg/ml on day 0 and 21.1 pg/ml on day 14. Reduction in IL-6 in asymptomatic patients was statistically highly significant (p=0.0035). Mean D-dimer was showing decreasing trend from day 0 to day 14 in mild symptomatic patients. In asymptomatic patients D dimer was 0.8 µg/ml on day 0 and 0.6 µg/ml on day 14. D-dimer decreased significantly from day 0 to day 14 (p value =0.0013). Mean LDH values on day 0 in mild symptomatic patients was 319.4 U/l and 219.3 on day 14. The reduction in LDH values in mild symptomatic patients is statistically significant (p value <0.0122). In asymptomatic patients mean LDH values on day 0 was 237 U/l and 194 U/l on day 14. The reduction in LDH values in asymptomatic group was statistically significant. Mean CRP values in mild symptomatic patients on day 0 was 12.2 mg/l and 3.8 mg/l on day 14. There was significant reduction in CRP values in mild symptomatic group which was statistically significant (p value =0.0546). Mean CRP values in asymptomatic patients on day 0 was 4.9 mg/l and 2.8 mg/l on day 14. There was significant reduction in mean CRP in asymptomatic patients which was statistically significant (p value =0.0446). In the present study all 40 patients (100%) cleared the virus and became negative for RT PCR test within 6 days. None of the patients progressed to severe COVID-19 and none of the patients succumbed to the disease.Conclusions: Azadvir accelerated recovery of COVID-19 patients by RT-PCR conversion, early improvement in clinical symptoms and immune markers in this study. This study results clearly indicates that azadvir has antiviral, immune booster activity and has definitive role in the management of asymptomatic to mild COVID-19 patients along with standard of care (CTRI no. CTRI/2020/06/026181).

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D-dimer level in COVID-19 infection: a systematic review

Cited by 303 publications

References 73 publications

Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study

Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study

Comparative study of hematological and radiological feature of severe/critically ill patients with COVID-19, Influenza A H7N9 and H1N1 pneumonia

A prospective, open label clinical study to evaluate the safety, efficacy and tolerability of azadvir herbal steam inhaler in asymptomatic, mildly symptomatic COVID-19 patients and health care workers posted to covid wards

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