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Deprecated: Implicit conversion from float 269.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Clin+Med+(Lond) 2021 ; 21 (2): e155-e160 Nephropedia Template TP
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To scan or not to scan - D-dimers and computed tomography pulmonary angiography in the era of COVID-19 #MMPMID33593831
Tuck AA; White HL; Abdalla BA; Cartwright GJ; Figg KR; Murphy EN; Pyrke BC; Reynolds MA; Taha RM; Haboubi HN
Clin Med (Lond) 2021[Mar]; 21 (2): e155-e160 PMID33593831show ga
The COVID-19 pandemic has had many ramifications on healthcare delivery and practice. As part of this, utilising biomarkers to risk stratify patients has become increasingly popular. During the COVID-19 pandemic the use of D-dimer has increased due to the evidence of COVID-19 induced thrombo-embolic disease. We evaluated the use of D-dimer on all hospital admissions during the peak of the pandemic and evaluated its sensitivity in diagnosing pulmonary embolic disease (PE). Patients without COVID-19 infection were as likely to have evidence of PE as their COVID-positive counterparts. However, the sensitivity of a D-dimer was higher in COVID-positive patients at a lower D-dimer level (>1,500 mug/L, sensitivity 81%, specificity 70%) than in those without clinical, immunological or radiological evidence of COVID-19 infection (D-dimer >2,000 mug/L, sensitivity 80%, specificity 76%). These data suggest higher D-dimer thresholds should be considered for the exclusion of pulmonary emboli.