D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study

作者：Yumeng Yao, Jiatian Cao, Qingqing Wang, Qingfeng Shi, Kai Liu, Zhe Luo, Xiang Chen, Sisi Chen, Kaihuan Yu, Zheyong Huang, Bijie Hu · 发表于：Journal of Intensive Care · 年份：2020 · DOI：10.1186/s40560-020-00466-z · 被引用次数：661 · 研究领域：COVID-19 Clinical Research Studies、Long-Term Effects of COVID-19、Dermatological and COVID-19 studies

Abstract Background Over 5,488,000 cases of coronavirus disease-19 (COVID-19) have been reported since December 2019. We aim to explore risk factors associated with mortality in COVID-19 patients and assess the use of D-dimer as a biomarker for disease severity and clinical outcome. Methods We retrospectively analyzed the clinical, laboratory, and radiological characteristics of 248 consecutive cases of COVID-19 in Renmin Hospital of Wuhan University, Wuhan, China from January 28 to March 08, 2020. Univariable and multivariable logistic regression methods were used to explore risk factors associated with in-hospital mortality. Correlations of D-dimer upon admission with disease severity and in-hospital mortality were analyzed. Receiver operating characteristic curve was used to determine the optimal cutoff level for D-dimer that discriminated those survivors versus non-survivors during hospitalization. Results Multivariable regression that showed D-dimer > 2.0 mg/L at admission was the only variable associated with increased odds of mortality [OR 10.17 (95% CI 1.10–94.38), P = 0.041]. D-dimer elevation (≥ 0.50 mg/L) was seen in 74.6% (185/248) of the patients. Pulmonary embolism and deep vein thrombosis were ruled out in patients with high probability of thrombosis. D-dimer levels significantly increased with increasing severity of COVID-19 as determined by clinical staging (Kendall’s tau-b = 0.374, P = 0.000) and chest CT staging (Kendall’s tau-b = 0.378, P = 0.000). In-h...