Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey.
Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey.
Am J Emerg Med. 2021 Feb;40:55-59. doi: 10.1016/j.ajem.2020.12.023. Epub 2020 Dec 14.
This study seeks to determine the utility of D-dimer levels as a biomarker in determining disease severity and prognosis in COVID-19.
Clinical, imaging and laboratory data of 120 patients whose COVID-19 diagnosis based on RT-PCR were evaluated retrospectively. Clinically, the severity of COVID-19 was classified as noncomplicated or mild or severe pneumonia. Radiologically, the area of affected lungs compatible with viral pneumonia in each patient's computed tomography was classified as either 0-30% or ≥ 31% of the total lung area. The D-dimer values and laboratory data of patients with COVID-19 were compared with inpatient status, duration of hospitalization, and lung involvement during treatment and follow-up. To assess the predictive value of D-dimer, receiver operating characteristic (ROC) analysis was conducted.
D-dimer elevation (> 243 ng/ml) was detected in 63.3% (76/120) of the patients. The mean D-dimer value was calculated as 3144.50 ± 1709.4 ng/ml (1643-8548) for inpatients with severe pneumonia in the intensive care unit. D-Dimer values showed positive correlations with age, duration of stay, lung involvement, fibrinogen, neutrophil count, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR). When the threshold D-dimer value was 370 ng/ml in the ROC analysis, this value was calculated to have 77% specificity and 74% sensitivity for lung involvement in patients with COVID-19.
D-Dimer levels in patients with COVID-19 correlate with outcome, but further studies are needed to see how useful they are in determining prognosis.
本研究旨在确定 D-二聚体水平作为 COVID-19 疾病严重程度和预后的生物标志物的效用。
回顾性评估了 120 名基于 RT-PCR 诊断为 COVID-19 的患者的临床、影像学和实验室数据。临床上，将 COVID-19 的严重程度分为非复杂性或轻度或重度肺炎。影像学上，将每位患者 CT 扫描中与病毒性肺炎相符的受影响肺部区域分为总肺面积的 0-30%或≥31%。将 COVID-19 患者的 D-二聚体值和实验室数据与住院状态、住院时间以及治疗和随访期间的肺部受累情况进行比较。为了评估 D-二聚体的预测价值，进行了接收者操作特征（ROC）分析。
在 63.3%（76/120）的患者中检测到 D-二聚体升高（> 243 ng/ml）。在重症监护病房中患有严重肺炎的住院患者中，平均 D-二聚体值计算为 3144.50 ± 1709.4 ng/ml（1643-8548）。D-二聚体值与年龄、住院时间、肺部受累、纤维蛋白原、中性粒细胞计数、中性粒细胞淋巴细胞比（NLR）和血小板淋巴细胞比（PLR）呈正相关。当 ROC 分析中的阈值 D-二聚体值为 370 ng/ml 时，该值计算出对 COVID-19 患者肺部受累的特异性为 77%，敏感性为 74%。
COVID-19 患者的 D-二聚体水平与结局相关，但需要进一步研究以确定其在确定预后方面的有用性。
