Does D-dimer levels on admission predicts venous thromboembolism in patients with COVID-19?

Abstract

D-dimer elevation has been reported to be one of the common laboratory findings noted in Covid-19 patients.However, the optimal cutoff for D-dimer on admission to predict venous thromboembolism (VTE) in patients with COVID-19 has not been well evaluated.

Our study aimes to evaluate the D‐dimer cut‐off value to predicting VTE in COVID-19 patients.

Patients with laboratory confirmed Covid-19 were retrospective enrolled in the pulmonary departement B at Abderrahmen Mami hospital, Tunisia, from March 2020 to January 2021.D-dimer levels on admission and venous thrombotic events were collected to calculate the optimum cutoff using receiver operating characteristic curves. According to the cutoff, the subjects were divided into two groups.

A total of 200 patients were enrolled in our study, with a median age of 64,9[22– 98]years. The incidence of VTE was 15% (30/200) of which 16% occured on thrombosis prophylaxis. Pulmonary embolism occured in 21 patients and deep venous thrombosis in 9 patients. The optimum cutoff value of D-dimer to predict VTE was 1.4 μg/ml using ROC curve with a sensitivity of 82.3% and a specificity of 85.3%. Area under the ROC curve for VTC was 0.89. There were 81 patients with D-dimer≥1,4 μg/ mL and 119 patients with D-dimer<1,4 μg/m on admission. Patients with D-dimer levels≥1,4.μg/mL had a higher incidence of VTE(P<0.001). They also had higher incidence of underlying disease, such as diabetes(P =0.007)and hypertension(P<0.001). Lower level of lymphocyte(P =0.03)and higher level of C-reactive protein(P=0.04), were also observed in those with D-dimer levels ≥1.4 μg/mL.

D-dimer on admission greater than 1.4 μg/mL could be an early and helpful marker to prevent VTE in COVID-19 patients.