The Role of D-Dimers in the Initial Evaluation of COVID-19

Abstract

Purpose The COVID-19 pandemic was noted for the high degree of contagion and the large number of cases, as well as for the various clinical forms, from asymptomatic towards rapid evolution to death. The hospitals limited care capacity imposed the need to identify some markers of unfavorable evolution. The purpose of our study is to identify the parameters correlated with COVID-19 unfavorable evolution and to draw the profile of the patient at risk of unfavorable evolution. This set of parameters will help the doctor in deciding whether to hospitalize a patient and in choosing the treatment. Patients and Methods We performed a prospective, observational, actively controlled study on 849 patients with COVID-19, hospitalized in the Second Clinic of “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital Galati, Romania, between 1.03.2020–30.11.2020. Results The parameters statistically significant modified at the admission of the patients with COVID-19 unfavorable evolution were age, oxygen saturation, D-dimers, creatine kinase (CK), troponin, erythrocytes sedimentation rate (ESR), leukocytes, lymphocytes, neutrophils, platelets, hemoglobin (Hb), aspartate transaminase (AST), total and direct bilirubin (TBIL, DBIL), urea, creatinine, serum glucose. Strong correlations were observed between the unfavorable evolution and the admission values of D-dimers, AST, TBIL and between D-dimers and AST, which suggests that D-dimers levels can be considered predictive for the alteration of liver function and for the negative prognosis of the patient. Conclusion Coagulation disorders and acute respiratory failure are the prevailing causes of death from COVID-19. Together with other parameters that constitute the risk profile for severe COVID-19 evolution, the D-dimers dosing at admission proved to be extremely useful in the management of COVID-19.

Blood coagulation, risk factors and associated complications in COVID-19 patients in Saudi Arabia: A retrospective cohort study

“…[11] Intriguingly, elevated levels of DD were reported in severe COVID-19 illness compared to mild infection emphasizing its prognostic value in COVID-19 infection. [19] Parallel to CBC, an altered coagulation profile was observed between the 2 groups. Here, we found that elevated coagulation parameters are associated with poor prognosis, with an increase in PT (31.5%), PTT (10.5%), INR (26.3%), and DD (36.8%) among non-survivors.…”

Hereditary Hemorrhagic Telangiectasia Associating Neuropsychiatric Manifestations with a Significant Impact on Disease Management—Case Report and Literature Review

“…Although subjects suffering from COVID-19 are at increased risk of thrombosis, and we have strong evidence that subjects with HHT often suffer from medical conditions that may negatively influence the clinical course of COVID-19 (like chronic anemia, heart failure, and pulmonary AVMs), recent data suggest that, actually, HHT patients may generally present milder forms of SARS-CoV2 infection [ 70 , 71 , 72 , 73 , 74 , 75 , 76 ]. Some preliminary data show a significant decrease in inflammatory cytokines detected in the HHT population—with differences lower than 50% for some cytokines like interleukines (ILs: IL-6, IL-1β, and IL12p40) and around 50% for Chemokine (C-C motif) ligand 20 (CCL20), Thrombospondin-1 (TSP-1), and Activin A [ 70 , 71 , 72 , 73 , 74 , 75 , 76 ]. If confirmed by larger studies, these HHT characteristics may explain some sort of protection against developing severe forms of COVID-19 [ 70 , 71 , 72 , 73 ].…”

“…Some preliminary data show a significant decrease in inflammatory cytokines detected in the HHT population—with differences lower than 50% for some cytokines like interleukines (ILs: IL-6, IL-1β, and IL12p40) and around 50% for Chemokine (C-C motif) ligand 20 (CCL20), Thrombospondin-1 (TSP-1), and Activin A [ 70 , 71 , 72 , 73 , 74 , 75 , 76 ]. If confirmed by larger studies, these HHT characteristics may explain some sort of protection against developing severe forms of COVID-19 [ 70 , 71 , 72 , 73 ]. Our patient does not recall presenting with specific COVID-19 symptoms, but she opted for SARS-CoV2 vaccination in complete schedule as soon as it became available (March 2021).…”

Letter to the Editor: The Role of D-Dimers in the Initial Evaluation of COVID-19 [Letter]

“…I would like to applaud the authors on this original research into the role of D-dimers and other parameters that constitute the risk profile for severe COVID-19 evolution. 1 At this difficult time, research into the virus itself has been crucial in the effort to fight the global pandemic.…”