Association between D-Dimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and pooled analysis.
Coronavirus disease 2019
D-Dimer
Mortality
SARS-CoV-2
biomarker
Journal
Journal de medecine vasculaire
ISSN: 2542-4513
Titre abrégé: J Med Vasc
Pays: France
ID NLM: 101709200
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
03
05
2020
accepted:
18
05
2020
entrez:
1
9
2020
pubmed:
31
8
2020
medline:
5
9
2020
Statut:
ppublish
Résumé
Several observational studies have reported elevated baseline D-dimer levels in patients hospitalized for moderate to severe coronavirus disease 2019 (COVID-19). These elevated baseline D-dimer levels have been associated with disease severity and mortality in retrospective cohorts. To review current available data on the association between D-Dimer levels and mortality in patients admitted to hospital for COVID-19. We performed a systematic review of published studies using MEDLINE and EMBASE through 13 April 2020. Two authors independently screened all records and extracted the outcomes. A random effects model was used to estimate the standardized mean difference (SMD) with 95% confidence intervals (CI). Six original studies enrolling 1355 hospitalized patients with moderate to critical COVID-19 (391 in the non-survivor group and 964 in the survivor group) were considered for the final pooled analysis. When pooling together the results of these studies, D-Dimer levels were found to be higher in non-survivors than in-survivors. The SMD in D-Dimer levels between non-survivors and survivors was 3.59μg/L (95% CI 2.79-4.40μg/L), and the Z-score for overall effect was 8.74 (P<0.00001), with a high heterogeneity across studies (I Despite high heterogeneity across included studies, the present pooled analysis indicates that D-Dimer levels are significantly associated with the risk of mortality in COVID-19 patients. Early integration of D-Dimer testing, which is a rapid, inexpensive, and easily accessible biological test, can be useful to better risk stratification and management of COVID-19 patients.
Sections du résumé
BACKGROUND
BACKGROUND
Several observational studies have reported elevated baseline D-dimer levels in patients hospitalized for moderate to severe coronavirus disease 2019 (COVID-19). These elevated baseline D-dimer levels have been associated with disease severity and mortality in retrospective cohorts.
OBJECTIVES
OBJECTIVE
To review current available data on the association between D-Dimer levels and mortality in patients admitted to hospital for COVID-19.
METHODS
METHODS
We performed a systematic review of published studies using MEDLINE and EMBASE through 13 April 2020. Two authors independently screened all records and extracted the outcomes. A random effects model was used to estimate the standardized mean difference (SMD) with 95% confidence intervals (CI).
RESULTS
RESULTS
Six original studies enrolling 1355 hospitalized patients with moderate to critical COVID-19 (391 in the non-survivor group and 964 in the survivor group) were considered for the final pooled analysis. When pooling together the results of these studies, D-Dimer levels were found to be higher in non-survivors than in-survivors. The SMD in D-Dimer levels between non-survivors and survivors was 3.59μg/L (95% CI 2.79-4.40μg/L), and the Z-score for overall effect was 8.74 (P<0.00001), with a high heterogeneity across studies (I
CONCLUSIONS
CONCLUSIONS
Despite high heterogeneity across included studies, the present pooled analysis indicates that D-Dimer levels are significantly associated with the risk of mortality in COVID-19 patients. Early integration of D-Dimer testing, which is a rapid, inexpensive, and easily accessible biological test, can be useful to better risk stratification and management of COVID-19 patients.
Identifiants
pubmed: 32862984
pii: S2542-4513(20)30287-X
doi: 10.1016/j.jdmv.2020.05.003
pmc: PMC7250752
pii:
doi:
Substances chimiques
Biomarkers
0
Fibrin Fibrinogen Degradation Products
0
fibrin fragment D
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
268-274Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.
Références
Crit Care. 2020 Mar 18;24(1):108
pubmed: 32188484
CMAJ. 2004 Nov 23;171(11):1369-73
pubmed: 15557592
Thromb Res. 2019 Sep;181:77-83
pubmed: 31376606
Int J Mol Sci. 2017 Oct 27;18(11):
pubmed: 29077057
JAMA. 2020 Feb 24;:
pubmed: 32091533
PLoS One. 2020 Mar 19;15(3):e0230548
pubmed: 32191764
BMJ. 2020 Mar 26;368:m1091
pubmed: 32217556
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094
Thromb Haemost. 2020 May;120(5):876-878
pubmed: 32246450
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
J Thromb Haemost. 2020 Jun;18(6):1421-1424
pubmed: 32271988
J Thromb Haemost. 2020 Jul;18(7):1747-1751
pubmed: 32302448
Eur Heart J. 2020 May 14;41(19):1858
pubmed: 32227120
J Thromb Haemost. 2020 Jun;18(6):1324-1329
pubmed: 32306492
Intensive Care Med. 2020 Jun;46(6):1117-1120
pubmed: 32253448
J Thromb Haemost. 2020 Apr;18(4):844-847
pubmed: 32073213
JAMA Intern Med. 2020 Mar 13;:
pubmed: 32167524
BMC Med Res Methodol. 2005 Apr 20;5:13
pubmed: 15840177
JAMA. 2020 Feb 7;:
pubmed: 32031570
Nat Rev Immunol. 2020 May;20(5):269-270
pubmed: 32273594
Ann Palliat Med. 2020 Mar;9(2):428-436
pubmed: 32233642
J Thromb Haemost. 2020 May;18(5):1094-1099
pubmed: 32220112
J Thromb Haemost. 2020 Jul;18(7):1738-1742
pubmed: 32302438
N Engl J Med. 2020 Apr 23;382(17):e38
pubmed: 32268022
Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143
J Exp Med. 2020 Jun 1;217(6):
pubmed: 32302401
Lancet Haematol. 2020 May;7(5):e362-e363
pubmed: 32278361