Keywords
COVID-19
Venous thromboembolism
How to Cite
Abstract
D-Dimer (DD) is a coagulation and fibrinolysis activation marker available for the exclusion of venous thromboembolism (VTE) in patients with low pretest clinical probability. The International Society of Thrombosis and Haemostasis (ISTH) published in 2020 an interim guideline for risk stratification at the time of admission of patients with COVID-19 based on laboratory parameters. It proposes to evaluate in order of importance: DD value, prothrombin time, platelet count and fibrinogen dosage. The authors emphasize that although a cut-off value cannot be set for DD, values that are 3 to 4 times above the upper limit of the normal range used in each laboratory can be considered high. Although there is growing evidence supporting the adverse prognostic value associated with high levels of DD on admission in patients with COVID-19, it is limited in our setting. The objective of this study was to evaluate the prognostic value of determining DD on admission in patients with COVID-19 who were treated at Hospital Universitario Austral and Hospital Solidario COVID Austral. A retrospective analysis of DD results at admission was performed in patients with positive rt-PCR for SARS-CoV-2, from March 16 to July 28, 2020. The assay used was Biomerieux's D-Dimer Exclusion II, in the VIDAS 3 analyzer. 246 patients were evaluated, of whom 207 were not admitted to the Intensive Care Unit (ICU). The median DD in these patients was 553 ng/ml FEU (357-967 ng/ml FEU). The remaining 39 patients were admitted to the ICU and had a median DD of 974 ng/ mL (565-1895 ng/mL FEU). The risk of admission to the ICU with DD greater than 1,500 ng/ml FEU (at admission) was 35.89% and 11.59% in patients with DD less than 1,500 ng/ml FEU. RR: 3.1(95% CI 1.76-5.44; p=0.0001). The DD determined at admission in patients with COVID-19 has prognostic value. In our population of patients hospitalized for COVID-19, the risk of admission to the ICU was 3 times higher, in patients with DD values at admission greater than 1500 ng/ml FEU.
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