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Deprecated: Implicit conversion from float 263.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Med+Vasc 2020 ; 45 (5): 268-74 Nephropedia Template TP
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Association between D-Dimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and pooled analysis #MMPMID32862984
Sakka M; Connors J; Hékimian G; Martin-Toutain I; Crichi B; Colmegna I; Bonnefont-Rousselot D; Farge D; Frere C
J Med Vasc 2020[Sep]; 45 (5): 268-74 PMID32862984show ga
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: To review current available data on the association between D-Dimer levels and mortality in patients admitted to hospital for COVID-19. 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: 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 3.59 ?g/L (95% CI 2.79?4.40 ?g/L), and the Z-score for overall effect was 8.74 (P < 0.00001), with a high heterogeneity across studies (I2 = 95%). 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.