D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19 – ScienceOpen
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      D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19

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          Abstract

          Background

          The outbreak of the coronavirus disease 2019 (Covid‐19) shows a global spreading trend. Early and effective predictors of clinical outcomes is urgent needed to improve management of Covid‐19 patients.

          Objective

          The aim of the present study was to evaluate whether elevated D‐dimer levels could predict mortality in patients with Covid‐19.

          Methods

          Patients with laboratory confirmed Covid‐19 were retrospective enrolled in Wuhan Asia General Hospital from January 12, 2020 to March 15, 2020. D‐dimer levels on admission, and death events were collected to calculate the optimum cutoff using receiver operating characteristic curve. According to the cutoff, the subjects were divided into two groups. Then the in‐hospital mortality between two groups were compared to assess the predictive value of D‐dimer level.

          Results

          A total of 343 eligible patients were enrolled in the study. The optimum cutoff value of D‐dimer to predict in‐hospital mortality was 2.0 µg/ml with a sensitivity of 92.3% and a specificity of 83.3%. There were 67 patients with D‐dimer≥2.0 µg/ml, and 267 patients with D‐dimer <2.0 µg/ml on admission. 13 deaths occurred during hospitalization. Patients with D‐dimer levels≥2.0 µg/ml had a higher incidence of mortality when comparing to those who with D‐dimer levels < 2.0 µg/ml (12/67 vs 1/267, P<0.001, HR:51.5, 95%CI:12.9‐206.7).

          Conclusions

          D‐dimer on admission greater than 2.0µg/mL (fourfold increase) could effectively predict in‐hospital mortality in patients with Covid‐19, which indicated D‐dimer could be an early and helpful marker to improve management of Covid‐19 patients.

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          Author and article information

          Contributors
          zhenluzhangwh@163.com
          Journal
          J Thromb Haemost
          J. Thromb. Haemost
          10.1111/(ISSN)1538-7836
          JTH
          Journal of Thrombosis and Haemostasis
          John Wiley and Sons Inc. (Hoboken )
          1538-7933
          1538-7836
          19 April 2020
          : 10.1111/jth.14859
          Affiliations
          [ 1 ] Laboratory Medicine Wuhan Asia Heart Hospital No 753 Jinghan Avenue Wuhan China 430022
          [ 2 ] Physiology Group School of Nursing Wuhan Institute of Design and Science No.1 Yangqiaohu Avenue Wuhan China 430205
          [ 3 ] Laboratory Medicine Wuhan Asia General Hospital No.300 Taizihu north road Wuhan China 430056
          [ 4 ] Department of Cardiology Wuhan Asia Heart Hospital No 753 Jinghan Avenue Wuhan China 430022
          Author notes
          [*] [* ] Address correspondence to: Zhenlu Zhang

          Laboratory Medicine, Wuhan Asia Heart Hospital. No.753 Jinghan Avenue, Wuhan, China, 430022. Phone: 86‐18963980041; Fax: 86‐2785854036

          E‐mail address: zhenluzhangwh@ 123456163.com

          [†]

          Litao Zhang, Xinsheng Yan contribute equally to this work.

          Author information
          https://orcid.org/0000-0003-4918-611X
          Article
          JTH14859
          10.1111/jth.14859
          7264730
          32306492
          71a3cfdc-fc64-4928-8256-ee37e654db60
          This article is protected by copyright. All rights reserved.

          This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

          History
          Page count
          Figures: 0, Tables: 0, Pages: 18, Words: 599
          Categories
          Brief Report
          Brief Reports
          Custom metadata
          2.0
          accepted-manuscript
          Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.3 mode:remove_FC converted:02.06.2020

          Hematology
          coronavirus disease,sars‐cov‐2,d‐dimer,mortality,prognosis
          Hematology
          coronavirus disease, sars‐cov‐2, d‐dimer, mortality, prognosis

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