非 COVID-19 导致的急性呼吸窘迫综合征（ARDS）和 COVID-19 导致的 ARDS 患者的 D-二聚体水平：一项系统评价与荟萃分析。
D-dimer levels in non-COVID-19 ARDS and COVID-19 ARDS patients: A systematic review with meta-analysis.
机构信息
Doctoral School of Theoretical and Translational Medicine, Semmelweis University, Budapest, Hungary.
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
出版信息
PLoS One. 2023 Feb 6;18(2):e0277000. doi: 10.1371/journal.pone.0277000. eCollection 2023.
BACKGROUND
Hypercoagulability and thrombo-inflammation are the main reasons for death in COVID-19 patients. It is unclear whether there is a difference between D-dimer levels in patients without or with COVID-19 acute respiratory distress syndrome (ARDS).
METHODS
We searched PubMed, EMBASE, and ClinicalTrails.gov databases looking for studies reporting D-dimer levels in patients without or with COVID-19 ARDS. Secondary endpoints included length of hospital stay, and mortality data at the longest follow-up available.
RESULTS
We included 12 retrospective and 3 prospective studies with overall 2,828 patients, of whom 1,404 (49.6%) had non-COVID-19 ARDS and 1,424 had COVID-19 ARDS. D-dimer levels were not significantly higher in non-COVID-19 ARDS than in COVID-19 ARDS patients (mean 7.65 mg/L vs. mean 6.20 mg/L MD 0.88 [CI: -0.61 to 2.38] p = 0.25; I² = 85%) while the length of hospital stay was shorter (non-COVID-19 mean 37.4 days vs. COVID-19 mean 48.5 days, MD -10.92 [CI: -16.71 to -5.14] p < 0.001; I² = 44%). No difference in mortality was observed: non-COVID-19 ARDS 418/1167 (35.8%) vs. COVID-19 ARDS 467/1201 (38.8%).
CONCLUSIONS
We found no difference in the mean D-dimer levels between non-COVID-19 ARDS and COVID-19 ARDS patients.
背景
高凝状态和血栓炎症是 COVID-19 患者死亡的主要原因。目前尚不清楚 COVID-19 急性呼吸窘迫综合征（ARDS）患者与非 COVID-19 患者的 D-二聚体水平是否存在差异。
方法
我们检索了 PubMed、EMBASE 和 ClinicalTrails.gov 数据库，以寻找报告 COVID-19 非 ARDS 和 COVID-19 ARDS 患者 D-二聚体水平的研究。次要终点包括最长随访时间的住院时间和死亡率数据。
结果
我们纳入了 12 项回顾性研究和 3 项前瞻性研究，共纳入 2828 例患者，其中 1404 例（49.6%）为非 COVID-19 ARDS，1424 例为 COVID-19 ARDS。非 COVID-19 ARDS 患者的 D-二聚体水平并不明显高于 COVID-19 ARDS 患者（均值 7.65mg/L 比均值 6.20mg/L MD 0.88[CI:-0.61 至 2.38]p=0.25；I²=85%），但住院时间更短（非 COVID-19 平均 37.4 天，COVID-19 平均 48.5 天，MD-10.92[CI:-16.71 至-5.14]p<0.001；I²=44%）。死亡率无差异：非 COVID-19 ARDS 418/1167（35.8%）与 COVID-19 ARDS 467/1201（38.8%）。
结论
我们发现 COVID-19 非 ARDS 和 COVID-19 ARDS 患者的 D-二聚体平均水平无差异。
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