Predictive value of D-dimer in Covid-19

ABSTRACT

Background: The problem of determining the significance of individual laboratory markers that allows in the early stages of community-acquired pneumonia, in including during SARS-CoV- 2 infection, to predict both the nature of the course of the disease and possible poor prognosis. Aim(s) To assess the predictive value of an increased D-dimer in a new coronavirus infection caused by SARS-CoV- 2. Method(s) The diagnostic significance of the D-dimer level in predicting the severity of COVID19 infection was assessed based on the accumulated literature and real clinical practice. The methods of bibliographic and informational search in Scopus, CORE, eLIBRARY databases were used. The keywords for the search were D-dimer, DIC-syndrome, SARS-CoV- 2, COVID-19. A total of 52 literary sources were found, of which 21 articles were selected for further analysis. To study real clinical practice, the level of D-dimer was analyzed in 109 patients diagnosed with a confirmed new coronavirus infection caused by SARS-CoV- 2, moderate pneumonia, hospitalized in the covid department of the Volosevich First City Clinical Hospital in Arkhangelsk. Result(s) The D-dimer is the most significant marker of the severity of the disease and predicting the risk of death in SARS-CoV- 2 infection, both according to the literature and in real clinical practice. There is a relationship between the severity of the inflammatory process and the state of thrombinemia in community-acquired pneumonia of both bacterial and viral genesis, including influenza and SARS-CoV- 2 Conclusion(s) The main significance of elevated D-dimer levels in patients with COVID-19 is associated with the activation of coagulation against the background of systemic inflammation, ultimately leading to the disseminated intravascular coagulation syndrome, which must be taken into account in the treatment of the new coronavirus infection.