D-Dimer Levels for Diagnosis and Prognosis Assessment of COVID-19 Severity and Death

Abstract

Coagulopathy and increased levels of antiphospholipid antibodies are more prevalent in critically ill-COVID-19 patients and may predispose patients to both arterial and venous thrombotic diseases, due to blood circulation stasis, endothelial dysfunction, platelet activation, and excessive inflammation [1, 2]. D-dimer, a marker of fibrinolysis and a proxy for ongoing thrombosis is the sensitive change in coagulation parameters in COVID-19, whereas it has low specificity for the detection of venous thromboembolism [3]. A retrospective cohort study in France demonstrated that D-dimer levels at baseline significantly higher in patients with deep venous thrombosis (DVT) (p < 0.001), whereas the positive predictive values for venous thromboembolism (VTE) for baseline D-dimer levels that were equal to 1.0 µg/mL or more and more than 3 µg/mL were 44 % and 67 %, respectively and the negative predictive values for baseline D-dimer levels that was less than 1.0 µg/mL for VTE and pulmonary embolism (PE) were 90 % and 98 %, respectively [4]. VTE risk was predicted by elevated D-dimer concentrations of more than 1.0 µg/mL [4].