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Predictive value of D-dimer in the clinical outcome of severe COVID19 patients: Are we giving it too much credit?
Cidade, José P; Coelho, Luís; Costa, Vasco; Morais, Rui; Moniz, Patrícia; Morais, Luís; Fidalgo, Pedro; Tralhão, António; Paulino, Carolina; Nora, David; Valerio, Bernardino; Mendes, Vítor; Tapadinhas, Camila; Póvoa, Pedro.
  • Cidade JP; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Coelho L; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Costa V; Nova Medical School, Clinical Medicine, CHRC, New University of Lisbon, Lisbon, Portugal.
  • Morais R; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Moniz P; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Morais L; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Fidalgo P; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Tralhão A; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Paulino C; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Nora D; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Valerio B; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Mendes V; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Tapadinhas C; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
  • Póvoa P; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO, Lisbon.
Clin Appl Thromb Hemost ; 28: 10760296221079612, 2022.
Article in English | MEDLINE | ID: covidwho-1685921
ABSTRACT

BACKGROUND:

COVID-19 is a new form of acute respiratory failure leading to multiorgan failure and ICU admission. Gathered evidence suggests that a 3-fold rise in D-dimer concentrations may be linked to poor prognosis and higher mortality.

PURPOSE:

To describe D-dimer admission profile in severe ICU COVID19 patients and its predictive role in outcomes and mortality.

METHODS:

Single-center retrospective cohort study. All adult patients admitted to ICU with COVID19 were divided into 3 groups (1) Lower-values group (D-dimer levels < 3-fold normal range value [NRV] [500ng/mL]), Intermediate-values group (D-dimer ≥3-fold and <10-fold NRV) and Higher-value group (≥10-fold NRV).

RESULTS:

118 patients (mean age 63 years, 73% males) were included (N = 73 Lower-values group, N = 31 Intermediate-values group; N = 11 Higher-values group). Mortality was not different between groups (p = 0.51). Kaplan-Meier survival curves revealed no differences (p = 0.52) between groups, nor it was verified even when gender, age, ICU length of stay, and SOFA score were considered as covariables.

CONCLUSIONS:

In severe COVID19 patients, the D-dimer profile does not retain a predictive value regarding patients' survivability and should not be used as a surrogate of disease severity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Fibrin Fibrinogen Degradation Products / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Female / Humans / Male / Middle aged Language: English Journal: Clin Appl Thromb Hemost Journal subject: Vascular Diseases Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Fibrin Fibrinogen Degradation Products / COVID-19 Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Female / Humans / Male / Middle aged Language: English Journal: Clin Appl Thromb Hemost Journal subject: Vascular Diseases Year: 2022 Document Type: Article