Department of Medical Biochemistry, Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya, Turkey.
Department of Chest Diseases, Afyonkarahisar University Faculty of Medicine, Afyonkarahisar, Turkey.
Tuberk Toraks. 2020 Dec;68(4):353-360. doi: 10.5578/tt.70351.
Coronavirus disease 2019 (COVID-19) is a fatal and pandemic disease discovered in December 2019 in Wuhan, with lots of asymptomatic cases and a long incubation period. The researchers suggested that high d-dimer levels could predict disease severity, lung complications, and thromboembolic events before they occur.
We searched in PubMed, Scopus, and Web of Science using the keywords "D-dimer" and "coronavirus" or "D-dimer" and "COVID-19." We used Standardized Mean Differences (SMD) to build forest plots of continuous data and assess differences in serum D-dimer concentrations between severe and non-severe patients with COVID-19 disease. We evaluated p-value < 0.05 as statistically significant and preferred 95% confidence intervals (CIs).
The pooled results of all studies revealed that the D-dimer concentrations were significantly higher in patients with more severe COVID-19 (SMD: 2.32 μg/mL; 95% CI, 0.72 3.92 μg/mL, p< 0.001). We evaluated severe patients with total D-dimer levels. D-dimer concentrations were significantly higher in severe patients against total COVID-19 patients (SMD: 2.01 μg/mL; 95% CI, 0.25 to 3.77 μg/mL, p= 0.08).
We do not know the D-dimer increment mechanism in severe patients yet, but we think that these findings will be useful in the early diagnosis of severe disease and the first treatment.
2019 年冠状病毒病（COVID-19）是一种致命的、全球性的疾病，于 2019 年 12 月在武汉发现，有大量无症状病例和较长的潜伏期。研究人员提出，高 D-二聚体水平可在疾病严重程度、肺部并发症和血栓栓塞事件发生之前预测这些情况。
我们在 PubMed、Scopus 和 Web of Science 上使用关键词“D-二聚体”和“冠状病毒”或“D-二聚体”和“COVID-19”进行了搜索。我们使用标准化均数差（SMD）来构建 COVID-19 疾病严重和非严重患者血清 D-二聚体浓度的连续数据森林图，并评估它们之间的差异。我们将 p 值<0.05 视为具有统计学意义，并首选 95%置信区间（CI）。
所有研究的汇总结果表明，COVID-19 病情更严重的患者的 D-二聚体浓度明显更高（SMD：2.32μg/mL；95%CI，0.72 至 3.92μg/mL，p<0.001）。我们评估了总 D-二聚体水平的重症患者。与 COVID-19 总患者相比，重症患者的 D-二聚体浓度明显更高（SMD：2.01μg/mL；95%CI，0.25 至 3.77μg/mL，p=0.08）。
我们尚未了解重症患者 D-二聚体升高的机制，但我们认为这些发现将有助于早期诊断严重疾病和首次治疗。
