D-Dimer Concentrations and COVID-19 Severity: A Systematic Review and Meta-Analysis

Frontiers in Public Health

article

Panagiotis Paliogiannis¹  Arduino Aleksander Mangoni²  Paola Dettori³  Gheyath K. Nasrallah⁴  Gianfranco Pintus⁶  Angelo Zinellu⁷ 

[1] Department of Medical, Surgical and Experimental Sciences, University of Sassari;Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University;Cure and Health Center;Department of Biomedical Sciences, College of Health Sciences, Qatar University;Biomedical Research Centre, Qatar University;Department of Medical Laboratory Sciences, College of Health Sciences, and Sharjah Institute for Medical Research, University of Sharjah, United Arab Emirates;Biomedical Sciences, University of Sassari

关键词: D-dimer;    coagulation;    thrombosis;    COVID-19;    SARS-CoV-2;   

DOI  :  10.3389/fpubh.2020.00432

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Coronavirus disease 2019 (COVID-19) is a recently described infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since late 2019, COVID-19 has rapidly spread in virtually all countries, imposing the adoption of significant lockdown and social distancing measures. The activation of the coagulation cascade is a common feature of disseminated intravascular coagulation and adverse clinical outcomes in COVID-19 patients. In this study, we conducted a meta-analysis aiming to investigate differences in serum D-dimer concentrations in patients with and without severe COVID-19 disease. An electronic search in Medline (PubMed), Scopus and Web of Science was performed with no language restrictions, and 13 articles were reporting on 1,807 patients (585, 32.4% with severe disease) were finally identified and included in the meta-analysis. The pooled results of all studies revealed that the D-dimer concentrations were significantly higher in patients with more severe COVID-19 (SMD: 0.91 mg/L; 95% CI, 0.75 to 1.07 mg/L, p < 0.0001). The heterogeneity was moderate ( I 2 = 46.5%; p = 0.033). Sensitivity analysis showed that the effect size was not modified when any single study was in turn removed (effect size range, 0.87 mg/L to 0.93 mg/L). The Begg's ( p = 0.76) and Egger's tests ( p = 0.38) showed no publication bias. In conclusion, our systematic review and meta-analysis showed that serum D-dimer concentrations in patients with severe COVID-19 are significantly higher when compared to those with non-severe forms.

【 授权许可】

CC BY