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D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19.
J Thromb Haemost. 2020 06; 18(6):1324-1329.JT

Abstract

BACKGROUND

The outbreak of the coronavirus disease 2019 (Covid-19) has shown a global spreading trend. Early and effective predictors of clinical outcomes are urgently needed to improve management of Covid-19 patients.

OBJECTIVE

The aim of the present study was to evaluate whether elevated D-dimer levels could predict mortality in patients with Covid-19.

METHODS

Patients with laboratory confirmed Covid-19 were retrospective enrolled in Wuhan Asia General Hospital from January 12, 2020, to March 15, 2020. D-dimer levels on admission and death events were collected to calculate the optimum cutoff using receiver operating characteristic curves. According to the cutoff, the subjects were divided into two groups. Then the in-hospital mortality between two groups were compared to assess the predictive value of D-dimer level.

RESULTS

A total of 343 eligible patients were enrolled in the study. The optimum cutoff value of D-dimer to predict in-hospital mortality was 2.0 µg/mL with a sensitivity of 92.3% and a specificity of 83.3%. There were 67 patients with D-dimer ≥2.0 µg/mL, and 267 patients with D-dimer <2.0 µg/mL on admission. 13 deaths occurred during hospitalization. Patients with D-dimer levels ≥2.0 µg/mL had a higher incidence of mortality when comparing with those who with D-dimer levels <2.0 µg/mL (12/67 vs 1/267, P < .001; hazard ratio, 51.5; 95% confidence interval, 12.9-206.7).

CONCLUSIONS

D-dimer on admission greater than 2.0 µg/mL (fourfold increase) could effectively predict in-hospital mortality in patients with Covid-19, which indicated D-dimer could be an early and helpful marker to improve management of Covid-19 patients. (Chinese Clinical Trial Registry: ChiCTR2000031428).

Authors+Show Affiliations

Laboratory Medicine, Wuhan Asia Heart Hospital, Wuhan, China. Physiology Group, School of Nursing, Wuhan Institute of Design and Science, Wuhan, China. Laboratory Medicine, Wuhan Asia General Hospital, Wuhan, China.Laboratory Medicine, Wuhan Asia General Hospital, Wuhan, China.Laboratory Medicine, Wuhan Asia Heart Hospital, Wuhan, China.Laboratory Medicine, Wuhan Asia General Hospital, Wuhan, China.Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China.Laboratory Medicine, Wuhan Asia General Hospital, Wuhan, China.Laboratory Medicine, Wuhan Asia Heart Hospital, Wuhan, China. Physiology Group, School of Nursing, Wuhan Institute of Design and Science, Wuhan, China. Laboratory Medicine, Wuhan Asia General Hospital, Wuhan, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32306492

Citation

Zhang, Litao, et al. "D-dimer Levels On Admission to Predict In-hospital Mortality in Patients With Covid-19." Journal of Thrombosis and Haemostasis : JTH, vol. 18, no. 6, 2020, pp. 1324-1329.
Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324-1329.
Zhang, L., Yan, X., Fan, Q., Liu, H., Liu, X., Liu, Z., & Zhang, Z. (2020). D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. Journal of Thrombosis and Haemostasis : JTH, 18(6), 1324-1329. https://doi.org/10.1111/jth.14859
Zhang L, et al. D-dimer Levels On Admission to Predict In-hospital Mortality in Patients With Covid-19. J Thromb Haemost. 2020;18(6):1324-1329. PubMed PMID: 32306492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. AU - Zhang,Litao, AU - Yan,Xinsheng, AU - Fan,Qingkun, AU - Liu,Haiyan, AU - Liu,Xintian, AU - Liu,Zejin, AU - Zhang,Zhenlu, PY - 2020/04/07/received PY - 2020/04/10/accepted PY - 2020/4/20/pubmed PY - 2020/6/11/medline PY - 2020/4/20/entrez KW - D-dimer KW - SARS-CoV-2 KW - coronavirus disease KW - mortality KW - prognosis SP - 1324 EP - 1329 JF - Journal of thrombosis and haemostasis : JTH JO - J Thromb Haemost VL - 18 IS - 6 N2 - BACKGROUND: The outbreak of the coronavirus disease 2019 (Covid-19) has shown a global spreading trend. Early and effective predictors of clinical outcomes are urgently needed to improve management of Covid-19 patients. OBJECTIVE: The aim of the present study was to evaluate whether elevated D-dimer levels could predict mortality in patients with Covid-19. METHODS: Patients with laboratory confirmed Covid-19 were retrospective enrolled in Wuhan Asia General Hospital from January 12, 2020, to March 15, 2020. D-dimer levels on admission and death events were collected to calculate the optimum cutoff using receiver operating characteristic curves. According to the cutoff, the subjects were divided into two groups. Then the in-hospital mortality between two groups were compared to assess the predictive value of D-dimer level. RESULTS: A total of 343 eligible patients were enrolled in the study. The optimum cutoff value of D-dimer to predict in-hospital mortality was 2.0 µg/mL with a sensitivity of 92.3% and a specificity of 83.3%. There were 67 patients with D-dimer ≥2.0 µg/mL, and 267 patients with D-dimer <2.0 µg/mL on admission. 13 deaths occurred during hospitalization. Patients with D-dimer levels ≥2.0 µg/mL had a higher incidence of mortality when comparing with those who with D-dimer levels <2.0 µg/mL (12/67 vs 1/267, P < .001; hazard ratio, 51.5; 95% confidence interval, 12.9-206.7). CONCLUSIONS: D-dimer on admission greater than 2.0 µg/mL (fourfold increase) could effectively predict in-hospital mortality in patients with Covid-19, which indicated D-dimer could be an early and helpful marker to improve management of Covid-19 patients. (Chinese Clinical Trial Registry: ChiCTR2000031428). SN - 1538-7836 UR - https://www.unboundmedicine.com/medline/citation/32306492/D_dimer_levels_on_admission_to_predict_in_hospital_mortality_in_patients_with_Covid_19_ DB - PRIME DP - Unbound Medicine ER -