Differences in D-Dimer Levels in Covid-19 Patients with Versus without Venous Thromboembolisms (Vte)

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID19) is known to cause coagulopathy as multiple systemic coagulation and inflammatory responses are activated during infectious complications. In COVID19 patients, hypercoagulopathy usually presents with an elevated D-dimer level. METHOD(S) All patients >= 18 years old who were admitted to NYU Langone Hospital-Long Island with a primary diagnosis of COVID-19 or with a flagged admission of COVID19 during April 1, 2020 to June 30, 2020 were included. IRB approval was acquired prior to data collection and upon permission, the clinical pharmacy IT department ran a report to identify patients. Most patients had a positive reverse-transcription polymerase chain reaction (RT-PCR) test during their admission, while a small number of patients were diagnosed before admission. Admissions included ICU patients or general ward patients. Series of D dimers were recorded. RESULT(S) There were 350 patients enrolled in the study, 331 had no VTE, 19 had VTE. Peak D dimer was 4876 (range 1509 to 15,872) in VTE group vs. 680 in non VTE group (range 257 to 2723). 47.4% of VTE group had peak D dimer greater than 5000 vs. 16% of non VTE group. Surprisingly, there was no difference in mortality between the two groups 26.3% for VTE group;19.9% in non VTE group, (p=0.556). However, VTE group had higher ICU admission rate 42.1% vs. 20.2% of non VTE group, p=0.039. Length of intubation was also significantly higher in VTE group (27 days) comparing to non VTE group (6 days), p=0.007. CONCLUSION(S) Covid 19 patients with VTE have much higher D dimer than non VTE Covid 19 patients. Although there is no difference in mortality in the two groups in our study, VTE group is associated with higher ICU admission as well as longer length of intubation days.