Elevated D-dimer levels on admission are associated with severity and increased risk of mortality in COVID-19: A systematic review and meta-analysis - 11/12/20
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Abstract |
Background |
In this systematic review and meta-analysis, we aimed to investigate the correlation of D-dimer levels measured on admission with disease severity and the risk of death in patients with coronavirus disease 2019 (COVID-19) pneumonia.
Materials and methods |
We performed a comprehensive literature search from several databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in abstracting data and assessing validity. Quality assessment was performed using the Newcastle-Ottawa quality assessment scale (NOS). D-dimer levels were pooled and compared between severe/non-severe and surviving/non-surviving patient groups. Weighted mean difference (WMD), risk ratios (RRs) and 95% confidence intervals (CIs) were analyzed.
Results |
Thirty-nine studies reported on D-dimer levels in 5750 non-severe and 2063 severe patients and 16 studies reported on D-dimer levels in 2783 surviving and 697 non-surviving cases. D-dimer levels were significantly higher in patients with severe clinical status (WMD: 0.45 mg/L, 95% CI: 0.34–0.56; p < 0.0001). Non-surviving patients had significantly higher D-dimer levels compared to surviving patients (WMD: 5.32 mg/L, 95% CI: 3.90–6.73; p < 0.0001). D-dimer levels above the upper limit of normal (ULN) was associated with higher risk of severity (RR: 1.58, 95% CI: 1.25–2.00; p < 0.0001) and mortality (RR: 1.82, 95% CI: 1.40–2.37; p < 0.0001).
Conclusion |
Increased levels of D-dimer levels measured on admission are significantly correlated with the severity of COVID-19 pneumonia and may predict mortality in hospitalized patients.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | The novel Coronavirus has caused a global outbreak of respiratory illness. |
• | Thrombotic complications and coagulopathies have become a major cause of morbidity and mortality. |
• | D-dimer is the degradation product of fibrin and reflects activation of coagulation and fibrinolysis. |
• | Elevated d-dimer levels are strongly associated with disease severity and increased mortality. |
Mappa
Vol 39
P. 173-179 - gennaio 2021 Ritorno al numero
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Benvenuto su EM|consulte, il riferimento dei professionisti della salute.