Background: D-dimer is a small protein fragment and high levels of D-dimer have been associated with increased mortality in patients presenting to emergency departments with infection. Previous studies have reported increased levels of D-dimer in COVID-19; however, it is unclear whether an increased D-dimer level provides early warning of poor prognosis. Therefore, this study aimed to assess the usefulness of D-dimer as an early indicator of prognosis in patients with coronavirus disease (COVID-19). Methods: We conducted a retrospective study of patients with COVID-19 admitted to Leishenshan Hospital in Wuhan, China, from February 15 to March 30, 2020. The final date of follow-up was April 11, 2020. Results: Of the 1,643 patients with COVID-19, 691 had elevated D-dimer levels. Their median age was 65 years. Of the patients with elevated D-dimer levels, 45% had comorbidities, with cardiovascular disease (205 [29.7%]) being the most common. Patients with elevated D-dimer were more likely to require treatment with high-flow oxygen, anticoagulation, antibiotics, and admission to the intensive care unit They were also more likely to have increased interleukin-6, monocytes, and lymphocytes. Patients with elevated D-dimer levels had significantly higher mortality than those with normal or low D-dimer levels. Conclusion: In patients with COVID-19, elevated D-dimer was associated with abnormal immunity, underlying disease, increased disease severity, and increased mortality. Taken together, D-dimer may be a marker for the early warning of disease severity and increased risk of death. These findings provide insights into the potential risk of elevated D-dimer in patients with COVID-19.
【저자키워드】 COVID-19, D-dimer, SARS–CoV–2, critically ill patients, prognostic indicator, 【초록키워드】 Treatment, coronavirus disease, Monocytes, Lymphocytes, Mortality, anticoagulation, intensive care, Immunity, Prognosis, disease severity, Infection, Comorbidities, interleukin-6, cardiovascular disease, Antibiotics, underlying disease, Retrospective study, Protein, Patient, death, Follow-up, Admission, marker, D-dimer level, High-flow oxygen, D-dimer levels, increased risk, median age, potential risk, poor prognosis, Final, increased mortality, previous study, Wuhan, China, reported, the patient, elevated, conducted, provide, significantly higher, presenting, patients with COVID-19, 【제목키워드】 Indicator, Wuhan, China, Ill,