D-dimer levels in non-COVID-19 ARDS and COVID-19 ARDS patients: A systematic review with meta-analysis

Abstract

Background Hypercoagulability and thrombo-inflammation are the main reasons for death in COVID-19 patients. It is unclear whether there is a difference between D-dimer levels in patients without or with COVID-19 acute respiratory distress syndrome (ARDS). Methods We searched PubMed, EMBASE, and ClinicalTrails.gov databases looking for studies reporting D-dimer levels in patients without or with COVID-19 ARDS. Secondary endpoints included length of hospital stay, and mortality data at the longest follow-up available. Results We included 12 retrospective and 3 prospective studies with overall 2,828 patients, of whom 1,404 (49.6%) had non-COVID-19 ARDS and 1,424 had COVID-19 ARDS. D-dimer levels were not significantly higher in non-COVID-19 ARDS than in COVID-19 ARDS patients (mean 7.65 mg/L vs. mean 6.20 mg/L MD 0.88 [CI: -0.61 to 2.38] p = 0.25; I² = 85%) while the length of hospital stay was shorter (non-COVID-19 mean 37.4 days vs. COVID-19 mean 48.5 days, MD -10.92 [CI: -16.71 to -5.14] p < 0.001; I² = 44%). No difference in mortality was observed: non-COVID-19 ARDS 418/1167 (35.8%) vs. COVID-19 ARDS 467/1201 (38.8%). Conclusions We found no difference in the mean D-dimer levels between non-COVID-19 ARDS and COVID-19 ARDS patients.

Vitamin D and Zinc Supplementation to Improve Treatment Outcomes among COVID-19 Patients in India: Results from a Double-Blind Randomized Placebo-Controlled Trial

“…Secondary outcomes were the duration of individual symptoms, need for assisted ventilation, duration of hospital stay (among inpatients), all-cause mortality, and blood biomarker concentrations. Blood biomarkers were measured both at baseline and endline (8 wk) and included nutritional measures (serum 25(OH)D and calcium, and zinc in whole blood) and immunological and inflammatory markers [serum ferritin, CRP, lactate dehydrogenase and plasma D-dimer (a protein product of fibrin degradation, that has been linked to inflammation and indicated as a biomarker of severity for COVID-19 in previous research)] [ 43 ], IL-6, angiopoietin-2, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), IgG and IgM]. Sample analysis was undertaken at nationally accredited laboratories (nutritional biomarkers all measured in a single laboratory using validated methods, ferritin, CRP, D-dimer, and lactate dehydrogenase) or at the Foundation for Medical Research (IL-6, angiopoietin-2, sTREM-1, IgG, and IgM).…”