Elevated D-Dimer levels are strongly associated with High Mortality Rate in COVID-19 patients. An observational Study

Elevated D-Dimers in COVID-19 Patients

Abstract

Severe acute respiratory syndrome called COVID-19, was declared as global health emergency and a pandemic due to its worldwide distribution and frightful spread. Patients are presented with severe respiratory illness along with thrombotic disorders. Elevated d-dimer level (>2000ng/ml) is a potentialpredictive biomarker of the disease outcome and prognosis. The objective of the present study isto find the association ofhigh d-dimer levels and mortality rate in COVID-19 patients to establish the optimal cutoff value for use in clinical setting. Methods: Present study enrolled 318COVID-19 patients admitted to Mayo Hospital, Lahore, Pakistan and confirmed by RT-PCR. On admission d-dimer levelof enrolled patients was measured by fluorescence immuno assay and reported in ng/ml. The enrolled subjects were divided in groupsbased on their age, gender, on admission d-dimer levels (<2000ng/ml and >2000ng/ml), outcome (survivors, non-survivors) and variant (α, β, and γ). Wilcoxon test was used to check the d-dimer level difference in survivor and non-survivor group. Results:81%patients (257/316) died and were categorized as non-survivors while 19% (61/318) were discharged after recovery and were categorized as survivors. Mean d-dimer levelfor survivor group was 2070ng/ml (±3060ng/ml) whereas for non-survivor group was 8010ng/ml (±5404ng/ml) and mean difference was statistically significant (p<0.05).D-dimer level washighest (upto 20,000ng/ml) in second wave(β-variant) as compared to other two wavesand caused highest number of deaths (n=163). Conclusion: Present study reports the d-dimer levels (>2000ng/ml)are strongly associated withhigh mortality rate in COVID-19 patients.