publication . Article . 2020

D-Dimers Level as a Possible Marker of Extravascular Fibrinolysis in COVID-19 Patients

Antonin Trimaille; Jecko Thachil; Benjamin Marchandot; Anais Curtiaud; Ian Leonard-Lorant; Adrien Carmona; Kensuke Matsushita; Chisato Sato; Laurent Sattler; Lelia Grunebaum; ...
Open Access English
  • Published: 24 Dec 2020 Journal: Journal of Clinical Medicine, volume 10, issue 1 (eissn: 2077-0383, Copyright policy)
  • Publisher: MDPI
Abstract
Background and Objective: Host defence mechanisms to counter virus infection include the activation of the broncho-alveolar haemostasis. Fibrin degradation products secondary to extravascular fibrin breakdown could contribute to the marked increase in D-Dimers during COVID-19. We sought to examine the prognostic value on lung injury of D-Dimers in non-critically ill COVID-19 patients without thrombotic events. Methods: This study retrospectively analysed hospitalized COVID-19 patients classified according to a D-Dimers threshold following the COVID-19 associated haemostatic abnormalities (CAHA) classification at baseline and at peak (Stage 1: D-Dimers less than three-fold above normal
Stage 3: D-Dimers six-fold above normal). The primary endpoint was the occurrence of critical lung injuries on chest computed tomography. The secondary outcome was the composite of in-hospital death or transfer to the intensive care unit (ICU). Results: Among the 123 patients included, critical lung injuries were evidenced in 8 (11.9%) patients in Stage 1, 6 (20%) in Stage 2 and 15 (57.7%) in Stage 3 (p = 0.001). D-Dimers staging at peak was an independent predictor of critical lung injuries regardless of the inflammatory burden assessed by CRP levels (OR 2.70, 95% CI (1.50&ndash
p = 0.008). Conclusions: In the absence of overt thrombotic events, D-Dimers quantification is a relevant marker of critical lung injuries and dismal patient outcome.
0.001) and was significantly associated with increased in-hospital death or ICU transfer (14.9 % in Stage 1, 50.0% in Stage 2 and 57.7% in Stage 3 (p &lt
0.001)). D-Dimers staging at peak was an independent predictor of in-hospital death or ICU transfer (OR 2.50, CI 95% (1.27&ndash
Stage 2: D-Dimers three- to six-fold above normal
p &lt
4.86)
4.93)
Persistent Identifiers
Fields of Science and Technology classification (FOS)
03 medical and health sciences, 0302 clinical medicine, 030204 cardiovascular system & hematology, 030212 general & internal medicine
Sustainable Development Goals (SDG)
2. Zero hunger
Subjects
free text keywords: Article, coronavirus, fibrinolysis, lung injury, respiratory distress syndrome, thrombosis, General Engineering, Fibrinolysis, medicine.medical_treatment, medicine, business.industry, business, Lung injury, Fibrin, biology.protein, biology, Gastroenterology, medicine.medical_specialty, Intensive care unit, law.invention, law, Thrombosis, medicine.disease, Internal medicine, Stage (cooking), Lung, medicine.anatomical_structure, Clinical endpoint, lcsh:Medicine, lcsh:R
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