Elevated D-dimer is associated with severity of COVID-19: A systematic review and meta-analysis Elevated D-dimer with severity of COVID-19:

Article Sidebar

PDF Download
Published Jul 31, 2022
DOI: https://doi.org/10.18103/mra.v10i7.2870

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

Hasna Jahan, MBBS
MPhil fellow, Institute of Environmental Science, University of Rajshahi
Tanzima Yeasmin, PhD
Professor and Chairman, Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh
Molay Roy, PhD
Former Research Fellow atNational Agricultural Research Organization, Tsukuba, Japan, & University of Guelph, Ontario, Canada.

Abstract

With the rapid increase of COVID-19 cases, identifying case severity has become a critical issue for hospital admission and intensive care treatment. Given that pre-existing comorbidities play a significant role in the severity, emerging evidence indicates coagulopathy becomes an independent condition that causes respiratory distress in COVID-19.


In this metanalysis, relevant literatures reporting D-dimer, a coagulation byproduct, in COVID-19 cases were synthesized and statistically analyzed to test if the D-dimer level can predict case severity and mortality.


The analysis found that D-dimer levels were higher in non-survivors/severe than in survivors/non-severe, (MD 0.64, 95% CI 0.52 to 0.75; participants = 5957, I2 = 98%). Subgroup analysis showed MD between non-survivors and survivors was MD 3.48 μg/mL (95% CI 2.69 to 4.27; participants = 1799; studies = 7; I2 = 86%) with Z-score 8.64, p<0.0001. In meta-regression, a significant correlation was observed between increased plasma mean D-dimer level with increased proportion case severity (P=0.046) and mortality (P=0.009).


Overall, the study found that the D-dimer level index can be a predictor of risk for case severity and mortality in COVID-19 patients. The test is rapid and inexpensive and can help clinicians prioritize medical care other than deciding therapeutic options for clinical goals.

Keywords: COVID-19, SARS-CoV-2, D-dimer, Coagulopathy, Risk, Management, Systematic Review, Meta-Analysis

Article Details

How to Cite
JAHAN, Hasna; YEASMIN, Tanzima; ROY, Molay. Elevated D-dimer is associated with severity of COVID-19: A systematic review and meta-analysis. Medical Research Archives, [S.l.], v. 10, n. 7, july 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2870>. Date accessed: 22 july 2024. doi: https://doi.org/10.18103/mra.v10i7.2870.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 10 No 7 (2022): Vol.10 Issue 7 July 2022
Section
Review Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Kaur N, Singh R, Dar Z, Bijarnia RK, Dhingra N, Kaur T. Genetic comparison among various coronavirus strains for the identification of potential vaccine targets of SARS-CoV2. Infection, Genetics and Evolution. 2021;89:104490.
2. Hatmal MM, Alshaer W, Al-Hatamleh MAI, et al. Comprehensive Structural and Molecular Comparison of Spike Proteins of SARS-CoV-2, SARS-CoV and MERS-CoV, and Their Interactions with ACE2. Cells. 2020;9(12).
3. Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet. 2020;395(10224):565-574.
4. Ma Q, Liu J, Liu Q, et al. Global Percentage of Asymptomatic SARS-CoV-2 Infections Among the Tested Population and Individuals With Confirmed COVID-19 Diagnosis: A Systematic Review and Meta-analysis. JAMA network open. 2021;4(12):e2137257-e2137257.
5. Saba L, Sverzellati N. Is COVID Evolution Due to Occurrence of Pulmonary Vascular Thrombosis? Journal of thoracic imaging. 2020.
6. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020.
7. Bounds EJ, Sankar P, Kok SJ. D Dimer. In: StatPearls. Treasure Island (FL)2020.
8. Lippi G, Bonfanti L, Saccenti C, Cervellin G. Causes of elevated D-dimer in patients admitted to a large urban emergency department. Eur J Intern Med. 2014;25(1):45-48.
9. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Journal of thrombosis and haemostasis : JTH. 2020;18(5):1094-1099.
10. Xiong M, Liang X, Wei YD. Changes in blood coagulation in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. British journal of haematology. 2020;189(6):1050-1052.
11. Rostami M, Mansouritorghabeh H. D-dimer level in COVID-19 infection: a systematic review. Expert Review of Hematology. 2020;13(11):1265-1275.
12. Sakka M, Connors JM, Hékimian G, et al. Association between D-Dimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and pooled analysis. JMV-Journal de Médecine Vasculaire. 2020;45(5):268-274.
13. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC medical research methodology. 2005;5:13.
14. Wang L, He W, Yu X, et al. Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up. The Journal of infection. 2020;80(6):639-645.
15. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of thrombosis and haemostasis : JTH. 2020;18(4):844-847.
16. Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. Bmj. 2020;368:m1091.
17. Wang Y, Lu X, Li Y, et al. Clinical Course and Outcomes of 344 Intensive Care Patients with COVID-19. American journal of respiratory and critical care medicine. 2020;201(11):1430-1434.
18. Zhang J, Liu P, Wang M, et al. The clinical data from 19 critically ill patients with coronavirus disease 2019: a single-centered, retrospective, observational study. Zeitschrift fur Gesundheitswissenschaften = Journal of public health. 2020:1-4.
19. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062.
20. Chen Q, Zheng Z, Zhang C, et al. Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China. Infection. 2020;48(4):543-551.
21. Fu J, Kong J, Wang W, et al. The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou China. Thromb Res. 2020;192:3-8.
22. Wan S, Xiang Y, Fang W, et al. Clinical features and treatment of COVID-19 patients in northeast Chongqing. Journal of medical virology. 2020;92(7):797-806.
23. Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;75(7):1730-1741.
24. Zhang G, Hu C, Luo L, et al. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2020;127:104364.
25. Zhu Z, Cai T, Fan L, et al. Clinical value of immune-inflammatory parameters to assess the severity of coronavirus disease 2019. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2020;95:332-339.
26. Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. Bmj. 2020;369:m1966.
27. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical chemistry and laboratory medicine. 2020;58(7):1021-1028.
28. Bansal A, Singh AD, Jain V, et al. The association of D-dimers with mortality, intensive care unit admission or acute respiratory distress syndrome in patients hospitalized with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Heart & Lung. 2021;50(1):9-12.
29. Fogarty H, Townsend L, Ni Cheallaigh C, et al. COVID19 coagulopathy in Caucasian patients. British journal of haematology. 2020;189(6):1044-1049.
30. Willyard C. Coronavirus blood-clot mystery intensifies. Nature. 2020;581(7808):250.
31. Kario K, Matsuo T, Kobayashi H. Which factors affect high D-dimer levels in the elderly? Thrombosis research. 1991;62(5):501-508.