Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China.
Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China.
Sci Rep. 2021 Jan 19;11(1):1830. doi: 10.1038/s41598-021-81300-w.
To explore the value, and influencing factors, of D-dimer on the prognosis of patients with COVID-19. A total of 1,114 patients with confirmed COVID-19 who were admitted to three designated COVID-19 hospitals in Wuhan, China from January 18, 2020, to March 24, 2020, were included in this study. We examined the relationship between peripheral blood levels of D-dimer, and clinical classification and prognosis, as well as its related influencing factors. D-dimer levels were found to be related to the clinical classification and the prognosis of clinical outcome. D-dimer levels were more likely to be abnormal in severely and critically ill patients compared with mild and ordinary cases, while D-dimer levels of patients who had died were significantly higher than those of surviving patients according to the results of the first and last lab tests. The results from ROC analyses for mortality risk showed that the AUCs of D-dimer were 0.909, YI was 0.765 at the last lab test, and a D-dimer value of 2.025 mg/L was regarded to be the optimal probability cutoff for a prognosis of death. In addition, we found that patients with advanced age, male gender, dyspnea symptoms, and some underlying diseases have a higher D-dimer value (p < 0.05). In short, D-dimer is related to the clinical classification and can be used to evaluate the prognosis of COVID-19 patients. The D-dimer value of 2.025 mg/L was the optimal probability cutoff for judging an outcome of death. Advanced age, male gender, dyspnea symptoms, and some underlying diseases are influencing factors for D-dimer levels, which impacts the prognosis of patients.
探讨 D-二聚体对 COVID-19 患者预后的价值和影响因素。本研究纳入了 2020 年 1 月 18 日至 3 月 24 日期间在中国武汉的三家指定 COVID-19 医院收治的 1114 例确诊 COVID-19 患者。我们检查了外周血 D-二聚体水平与临床分类和预后的关系及其相关影响因素。D-二聚体水平与临床分类和临床结局的预后有关。与轻症和普通病例相比，重症和危重症患者的 D-二聚体水平更有可能异常，而根据首次和最后一次实验室检测结果，死亡患者的 D-二聚体水平明显高于存活患者。用于死亡风险的 ROC 分析结果表明，D-二聚体的 AUC 为 0.909，最后一次实验室检测的 YI 为 0.765，D-二聚体值为 2.025mg/L 被认为是预后死亡的最佳概率截断值。此外，我们发现年龄较大、男性、呼吸困难症状和某些基础疾病的患者 D-二聚体值较高（p<0.05）。总之，D-二聚体与临床分类有关，可用于评估 COVID-19 患者的预后。D-二聚体值 2.025mg/L 是判断死亡结局的最佳概率截断值。高龄、男性、呼吸困难症状和某些基础疾病是 D-二聚体水平的影响因素，影响患者的预后。
