Table 1.
Studies on D-dimer levels in COVID-19 patients.
| Author/Country | Study Type | Patients (n/total) | Population | Outcomes |
|---|---|---|---|---|
| Zhang[29] China | Retrospective | 140 | Hospitalized COVID-19 patients | Admission D-dimer was greater in severe vs non-severe cases (400 vs 200 ng/mL, p < 0.001) |
| Tang[30] Wuhan, China | Retrospective | 183 | COVID-19 pneumonia | Non-survivors revealed significantly higher D-dimer [2120 ng/mL (770–5270) vs 610 ng/mL (350–1290), P = <0.001], longer PT [15. 5 vs 13.6, P < 0.001], and APTT [44.8 vs 41.2, P = 0.096] compared to survivors on admission. |
| Zhou[2] Wuhan, China | Retrospective | 54/191 Non-survivors |
Survivors vs non-survivors | Levels of D-dimer were elevated in non-survivors (>1000 ng/mL) compared with survivors and increased with illness deterioration (In-hospital death OR 18.42, 95% CI 2.64–128.55), P = 0.0033. PT was also longer in non-survivors 12.1 vs 11.4, P = 0.0004. |
| Wu[31] China | Retrospective | 201 | COVID-19 pneumonia patients who developed ARDS or died |
D-dimer and INR were higher in patients with ARDS vs those without (D-dimer 1160 vs 520 ng/mL, p < 0.001, unadjusted HR 1.03; INR 11.70 vs 10.60 s, p < 0.001, unadjusted HR 1.56). Among ARDS patients, D-dimer was greater in non-survivors (3950 vs 490 ng/mL, p 0.001, unadjusted HR 1.02) while aPTT was lower (24.10 vs 29.60 s, p 0.04). |
| Wang[32] Wuhan, China | Retrospective | 138 | ICU vs non-ICU COVID-19 pneumonia | On admission, D-dimer was elevated in ICU vs non-ICU patients (414,000 vs 166,000 ng/mL, p < 0.001) and in non-survivors versus survivors. No difference in PT, aPTT, or platelets. |
| Guan[1] China | Retrospective | 1099 | Hospitalized COVID-19 patients | Admission D-dimer > 500 ng/L was seen in 69.4% of patients with the primary endpoint (ICU admission, mechanical ventilation or death) vs 44.2% without these endpoints. |
| Huang[33] Wuhan, China | Prospective | 41 | ICU vs non-ICU COVID-19 patients | On admission, D-dimer and PT were elevated in ICU vs non-ICU patients (2400 vs 500 ng/mL, P = 0.0042), (12.2 vs 10.7 s, P = 0.012); respectively. No statistically significant difference in aPTT or platelets. |
| Han[34] China | Prospective | 94 + 40 healthy controls | Hospitalized COVID-19 patients compared to healthy controls | COVID-19 cases had lower anti-thrombin (85.46 vs 98.82%, p < 0.001), higher D-dimer (10,360 vs 260 ng/mL, p < 0.001), higher fibrin/FDP (33.83 vs 1.55 mg/L, p < 0.001), higher fibrinogen (5.02 vs 2.90 g/L, p < 0.001), and lower PT (80.59 vs 96.86%, p 0.001).D -dimer and FDP differed between severe and mild cases of COVID-19. |
| Liu[35] China | Prospective | 12 vs 10 control | SARS-CoV-2 infected patients given dipyridamole with prophylactic anticoagulation | There was an increase in lymphocyte and platelet count, decreasing D-dimer level in patients receiving DIP treatment compared to the control group. Seven out of 12 were discharged home. |
| Lippi[23] Italy | Pooled analysis of 4 RCTs | 553 | 22% severe COVID-19 | D-dimer was higher in COVID-19 patients with severe disease than those without (WMD: 2970 mg/L, 95% CI 2470–3460 mg/L, I2 94%, P < 0.001). |
| Chen[36] China | Retrospective | 1859 | Hospitalized patients from 7 Chinese centers | Cox regression showed an association between in-hospital mortality and activated partial thromboplastin (aPTT) per second increase (HR =1.04 [1.02, 1.05]; P < 0.001) and Log10 D-dimer per mg/l increase (HR =3.00 [2.17, 4.16]; P < 0.001) |
| Koleilat[37] USA | Retrospective case-control | 135 | Patients with COVID-19 who had duplex scanning | DVT occurred in 18 (13.3%) patients compared to 72/711 (10.1) patients who were COVID-19 negative or untested. Patients with DVT had higher D-dimer levels – both first and average in-hospital. |