Esmailian Mehrdad, Vakili Zohreh, Nasr-Esfahani Mohammad, Heydari Farhad, Masoumi Babak
Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Tanaffos. 2022 Apr;21(4):419-433.
COVID-19 disease began to spread all around the world in December 2019 until now; and in the early stage it may be related to high D-dimer level that indicates coagulation pathways and thrombosis activation that can be affected by some underlying diseases including diabetes, stroke, cancer, and pregnancy and it also can be associated with Chronic obstructive pulmonary disease (COPD). The aim of this article was to analyze D-dimer levels in COVID-19 patients, as D-dimer level is one of the measures to detect the severity and outcomes of COVID-19. According to the results of this study, there is a higher level of D-dimer as well as concentrations of fibrinogen in the disease onset and it seems that the poor prognosis is linked to a 3 to 4-fold increase in D-dimer levels. It is also shown that 76% of the patients with ≥1 D-dimer measurement, had elevated D-dimer and were more likely to have critical illness than those with normal D-dimer. There was an increase in the rates of adverse outcomes with higher D-dimer of more than 2000 ng/mL and it is associated with the highest risk of death at 47%, thrombotic event at 37.8%, and critical illness at 66%. It also found that diabetes and COPD had the strongest association with death in COVID-19. So, it is necessary to measure the D-dimer levels and parameters of coagulation from the beginning as well as pay attention to comorbidities that can help control and management of COVID-19 disease.
2019年12月至如今，新冠病毒疾病在全球范围内开始传播；在早期，它可能与高D - 二聚体水平有关，这表明凝血途径和血栓形成激活，可能受到一些基础疾病的影响，包括糖尿病、中风、癌症和妊娠，它还可能与慢性阻塞性肺疾病（COPD）相关。本文的目的是分析新冠病毒疾病患者的D - 二聚体水平，因为D - 二聚体水平是检测新冠病毒疾病严重程度和预后的指标之一。根据这项研究的结果，在疾病发作时D - 二聚体水平以及纤维蛋白原浓度较高，而且预后不良似乎与D - 二聚体水平增加3至4倍有关。研究还表明，在进行过≥1次D - 二聚体检测的患者中，76%的患者D - 二聚体升高，与D - 二聚体正常的患者相比，他们更有可能患危重病。D - 二聚体高于2000 ng/mL时不良结局发生率增加，且与47%的最高死亡风险、37.8%的血栓形成事件风险和66%的危重病风险相关。研究还发现，糖尿病和慢性阻塞性肺疾病与新冠病毒疾病死亡的关联最强。所以，从一开始就有必要检测D - 二聚体水平和凝血参数，并关注合并症，这有助于新冠病毒疾病的控制和管理。
