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Abstract
Introduction: Studies associated increased D-dimer (DD) with severe COVID-19.
Methods: Retrospective cohort of patients with suspicion of COVID-19 and DD measurement. Plasma levels of DD at first consultation and the DD peak during hospitalization were recorded (expressed in ng/mL FEU or as patient/age-adjusted expected ratio-P/AA DD-). COVID-19 positive and negative groups were compared. Factors associated with severity and death were evaluated in both groups.
Results: Out of 723 patients included, 162 were diagnosed with SARS-CoV2 infection. COVID-19 patients had lower levels of DD [465(226-880) vs 691(295-1823) ng/mL,p<0.0001] and P/AA DD [0.76(0.44-1.30) vs 1.21 (0.55-2.68),p<0.0001] than negative ones.. Patients with pneumonia had higher P/AA DD than those with upper airways infections in both groups. In COVID-19 patients with pneumonia, DD>500ng/mL at diagnosis was associated with an increased risk of severity, however it was not evidenced with P/AA DD>1. In this group, DD at admission was not different in deaths compared with survivors. Deceased COVID-19-negative patients had higher levels of DD
Conclusions: DD seems not to be a specific biomarker of COVID-19 infection, and its increase is more pronounced in patients who developed pneumonia from other etiologies. Considering age-adjusted DD reference values could avoid the overestimation of its prognostic value in COVID-19 patients.
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