Elevated D-dimer levels increase risk of severe and mortality among patients with COVID-19 infection

Objectives:
Do elevated D-dimer levels increase risk of severe and mortality among patients with COVID-19 infection?

Study design:
This review article included 18 studies (16 retrospective and 2 prospective) with a total of 3,682 COVID-19 patients.

Results and conclusions:   
The investigators found pooled weighted mean difference (WMD) demonstrated significantly elevated D-dimer levels in patients who died versus those who survived [WMD = 6.13 mg/L, 95% CI = 4.16 to 8.11, p 0.001].

The investigators found, similarly, the pooled mean D-dimer levels were significantly elevated in patients with severe COVID-19 infection [WMD = 0.54 mg/L, 95% CI = 0.28 to 0.80, p 0.001].

The investigators found the risk of mortality was fourfold higher in patients with positive D-dimer versus negative D-dimer [risk ratio = 4.11, 95% CI = 2.48 to 6.84, p 0.001] and the risk of developing severe disease was twofold higher in patients with positive D-dimer levels versus negative D-dimer [risk ratio = 2.04, 95% CI = 1.34 to 3.11, p 0.001].

The investigators concluded that patients with COVID-19 infection presenting with elevated D-dimer levels have an increased risk of severe disease and mortality.

Original title:
Underlying respiratory diseases, specifically COPD, and smoking are associated with severe COVID-19 outcomes: A systematic review and meta-analysis by Sanchez-Ramirez DC and Mackey D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391124/

Additional information of El Mondo:
Find more information/studies on coronavirus right here.

D-dimer (or D dimer) is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two D fragments of the fibrin protein joined by a cross-link.

The reference concentration of D-dimer is 250 ng/mL or 0.4 mcg/mL.