The Association between D-dimer Levels and Thromboembolism, Worsening Severity, and Mortality among Hospitalized Adults with COVID-19

Authors

  • Patricia Pauline M. Remalante-Rayco University of the Philippines Manila
  • Evelyn O. Salido UP Manila
  • Joey A. Tabula Asia Pacific Center for Evidence-based Healthcare
  • Maria Teresa S. Tolosa University of the Philippines Manila

DOI:

https://doi.org/10.47895/amp.vi0.4153

Keywords:

D-dimer, COVID-19, anticoagulation

Abstract

Objective. To assess the association between D-dimer and clinical outcomes in adults with COVID-19.

Methods. We reviewed published articles and preprints from MEDLINE, Cochrane Library, Cornell Open Access Publication (COAP), MedRxiv, and BioRxiv databases. We included cohort studies on the association between D-dimer and the outcomes of thromboembolism, mortality, and worsening severity among hospitalized adults with COVID-19.

Results. We found 25 observational studies on the association between D-dimer and the outcomes of thromboembolism, mortality, or worsening severity. There was an increased risk of thromboembolism (OR 5.61 [95% CI 3.97, 7.94]) with higher D-dimer levels across different COVID-19 severities. D-dimer levels are associated with higher in-hospital mortality (OR 5.57 [95% CI 2.74, 11.31]) and worsening severity manifesting as critical illness (OR 1.91 [95% CI 1.05, 3.48] to 2.58 [95% CI 1.57, 4.24]), disease progression (HR 2.846 [95% CI 2.10, 3.85]), or need for mechanical ventilation (HR 3.28 [95% CI 1.07, 10.10]). However, some methodological flaws, such as incomplete laboratory or follow-up data and concern on varied D-dimer cut-offs and definitions of worsening disease, raise some uncertainty in the widespread use of D-dimer as a prognostic marker.

Conclusion. A higher D-dimer value is associated with worse clinical outcomes among hospitalized adults with COVID-19 and may be a useful prognostic indicator.

Author Biographies

  • Patricia Pauline M. Remalante-Rayco, University of the Philippines Manila

    Department of Clinical Epidemiology/Student

  • Joey A. Tabula, Asia Pacific Center for Evidence-based Healthcare

    Asia Pacific Center for Evidence-based Healthcare, Consultant

  • Maria Teresa S. Tolosa, University of the Philippines Manila

    Department of Clinical Epidemiology, Student

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Published

2021-12-02

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Section

Articles

How to Cite

1.
The Association between D-dimer Levels and Thromboembolism, Worsening Severity, and Mortality among Hospitalized Adults with COVID-19. Acta Med Philipp [Internet]. 2021 Dec. 2 [cited 2025 Apr. 5];. Available from: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/4153

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