Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis
Author
Cerdà, Pau
Ribas, Jesús
Iriarte, Adriana
Mora-Luján, José María
Torres, Raquel
Del Río, Belén
Jofre, Héctor Ignacio
Ruiz, Yolanda
Huguet, Marta
Fuset, Mari Paz
Martínez-Yélamos, Sergio
Santos, Salud
Llecha, Núria
Corbella Virós, Xavier
Riera-Mestre, Antoni
Publication date
2020-12-28ISSN
1932-6203
Abstract
Background: A higher incidence of thrombotic events, mainly pulmonary embolism (PE), has been reported in hospitalized patients with COVID-19. The main objective was to assess clinical and laboratory differences in hospitalized COVID-19 patients according to occurrence of PE. Methods: This retrospective study included all consecutive patients hospitalized with COVID-19 who underwent a computed tomography (CT) angiography for PE clinical suspicion. Clinical data and median blood test results distributed into weekly periods from COVID-19 symptoms onset, were compared between PE and non-PE patients. Results: Ninety-two patients were included, 29 (32%) had PE. PE patients were younger (63.9 (SD 13.7) vs 69.9 (SD 12.5) years). Clinical symptoms and COVID-19 CT features were similar in both groups. PE was diagnosed after a mean of 20.0 (SD 8.6) days from the onset of COVID-19 symptoms. Corticosteroid boluses were more frequently used in PE patients (62% vs. 43%). No patients met ISTH DIC criteria. Any parameter was statistically significant or clinically relevant except for D-Dimer when comparing both groups. Median values [IQR] of D-dimer in PE vs non-PE patients were: week 2 (2010.7 [770.1–11208.9] vs 626.0 [374.0–2382.2]; p = 0.004); week 3 (3893.1 [1388.2–6694.0] vs 1184.4 [461.8–2447.8]; p = 0.003); and week 4 (2736.3 [1202.1–8514.1] vs 1129.1 [542.5–2834.6]; p = 0.01). Median fold-increase of D-dimer between week 1 and 2 differed between groups (6.64 [3.02–23.05] vs 1.57 [0.64–2.71], p = 0.003); ROC curve AUC was 0.879 (p = 0.003) with a sensitivity and specificity for PE of 86% and 80%, respectively. Conclusions: Among hospitalized COVID-19 patients, D-dimer levels are higher at weeks 2, 3 and 4 after COVID-19 symptom onset in patients who develop PE. This difference is more pronounced when the fold increase between weeks 1 and 2 is compared.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
Keywords
Embòlia pulmonar
Hospitals--Pacients
COVID-19 (Malaltia)
Corticosteroides
Embolia pulmonar
Hospitalizados
COVID-19
Corticosteroides
Pulmonary embolism
Hospitals--Patients
COVID-19
Corticosteroids
Pages
15
Publisher
Public Library of Science
Collection
15; 12
Is part of
PLoS One
Citation
Cerdà, Pau; Ribas, Jesus; Iriarte, Adriana [et al.]. Blood test dynamics in hospitalized COVID-19 patients: Potential utility of D-dimer for pulmonary embolism diagnosis. PLoS One, 2020, 15(12), e0243533. Disponible en: <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243533>. Fecha de acceso: 2 feb. 2021. DOI: 10.1371/journal.pone.0243533
This item appears in the following Collection(s)
- Ciències de la Salut [740]
Rights
©2020 Cerdà et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/