Evaluation of variation in D-dimer levels among COVID-19 and bacterial pneumonia: a retrospective analysis
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Evaluation of variation in D‑dimer levels among COVID‑19 and bacterial pneumonia: a retrospective analysis Bilian Yu1,9 · Xin Li2,9 · Jin Chen1 · Mingqi Ouyang1 · Hong Zhang3,9 · Xinge Zhao4,9 · Liang Tang1,9 · Qin Luo1 · Min Xu5,9 · Lizhen Yang6,9 · Guxiang Huang7,9 · Xianling Liu8,9 · Jianjun Tang1,9
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract In the recent outbreak of novel coronavirus infection worldwide, the risk of thrombosis and bleeding should be concerned. We aimed to observe the dynamic changes of D-dimer levels during disease progression to evaluate their value for thrombosis. In this study, we report the clinical and laboratory results of 57 patients with confirmed COVID-19 pneumonia and 46 patients with confirmed community-acquired bacterial pneumonia (CAP). And their concentrations of D-dimer, infection-related biomarkers, and conventional coagulation were retrospectively analyzed. The Padua prediction score is used to identify patients at high risk for venous thromboembolism (VTE). The results found that, on admission, both in COVID-19 patients and CAP patients, D-dimer levels were significantly increased, and compared with CAP patients, D-dimer levels were higher in COVID-19 patients (P < 0.05). Besides, we found that in COVID-19 patients, D-dimer were related with markers of inflammation, especially with hsCRP (R = 0.426, P < 0.05). However, there was low correlation between VTE score and D-dimer levels (Spearman’s R = 0.264, P > 0.05) weakened the role of D-dimer in the prediction of thrombosis. After treatments, D-dimer levels decreased which was synchronous with hsCRP levels in patients with good clinical prognosis, but there were still some patients with anomalous increasing D-dimer levels after therapy. In conclusion, elevated baseline D-dimer levels are associated with inflammation but not with VTE score in COVID-19 patients, suggesting that it is unreasonable to judge whether anticoagulation is needed only according to D-dimer levels. However, the abnormal changes of D-dimer and inflammatory factors suggest that anticoagulant therapy might be needed. Keywords D-dimer · COVID-19 · Bacterial pneumonia · Retrospective analysis
Highlights • After COVID-19 outbreaks, the risk of thrombosis and
bleeding has attracted much attention.
• It has been reported that abnormal D-dimer levels are
associated with poor prognosis.
Bilian Yu and Xin Li make equal effort to this paper. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11239-020-02171-y) contains supplementary material, which is available to authorized users. * Xianling Liu [email protected] * Jianjun Tang [email protected] Extended author information available on the last page of the article
• D-dimer levels were higher in COVID-19 patients and
were related with markers of inflammation, and after treatments, D-dimer levels decreased which was synchronous with hsCRP levels in patients with good clinical prognosis. Also, the low correlation betwe
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