D-dimer dynamics in hospitalized COVID-19 patients: potential utility for diagnosis of pulmonary embolism
| Autor: | Pau Cerdà, Jesús Ribas, Héctor Ignacio Jofre, Yolanda Ruiz, José María Mora-Luján, Marta Huguet, Maria Paz Fuset, Adriana Iriarte, Raquel Torres, Sergio Martínez-Yélamos, Núria Llecha, Belen Del Rio, Xavier Corbella, Antoni Riera-Mestre, Salud Santos |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) medicine.diagnostic_test business.industry medicine.drug_class Incidence (epidemiology) Retrospective cohort study medicine.disease Gastroenterology Pulmonary embolism Internal medicine Angiography D-dimer medicine Corticosteroid Blood test business |
| DOI: | 10.1101/2020.09.21.20193953 |
| Popis: | BackgroundA higher incidence of thrombotic events, mainly pulmonary embolism (PE), has been reported in hospitalized patients with COVID-19. The main objective was to assess clinical and weekly laboratory differences in hospitalized COVID-19 patients according to occurrence of PE.MethodsThis retrospective study included all consecutive patients hospitalized with COVID-19 who underwent a computed tomography (CT) angiography for PE clinical suspicion. Clinical data and median blood test results distributed into weekly periods from COVID-19 symptoms onset were compared between PE and non-PE patients.ResultsNinety-two patients were included, 29 (32%) had PE. PE patients were younger (63.9 (SD13.7) vs 69.9 (SD12.5) years). Clinical symptoms and COVID-19 CT features were similar in both groups. PE was diagnosed after a mean of 20.0 (SD8.6) days from the onset of COVID-19 symptoms. Corticosteroid boluses were more frequently used in PE patients (62% vs. 43%). Median values [IQR] of D-dimer in PE vs non-PE patients were: week 2 (2010.7 [770.1-11208.9] vs 626.0 [374.0-2382.2]; p=0.04); 3 (3893.1 [1388.2-6694.0] vs 1184.4 [461.8-2447.8]; p=0.03); and 4 (2736.3 [1202.1-8514.1] vs 1129.1 [542.5-2834.6]; p=0.01). Median fold-increase of D-dimer between week 1 and 2 differed between groups (6.64 [3.02-23.05] vs 1.57 [0.64-2.71], p=0.003); ROC curve AUC was 0.879 (p=0.003) with a sensitivity and specificity for PE of 86% and 80%, respectively.ConclusionsAmong hospitalized COVID-19 patients, D-dimer levels are higher at weeks 2, 3 and 4 after COVID-19 symptom onset in patients who develop PE. This difference is more pronounced when the fold increase between weeks 1 and 2 is compared. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|