D-dimer level is a useful predictor for mortality in patients with COVID-19: Analysis of 483 cases

Background and aims : COVID-19 is a multi-system disease, with coagulation abnormalities D-dimer levels are increased in this disease We aimed to determine the association of D-dimer levels and mortality and to establish its optimal cut off values in predicting mortality Association of D-dimer levels with Diabetes Mellitus has also been established Methods : Information on 483 patients with confirmed COVID-19 was retrospectively collected and analyzed The optimal D-dimer cutoff point and C-statistic of routine tests both on admission and during hospital stay were evaluated by receiver operator characteristic (ROC) curve Results : The D-dimer elevation (≥0 50 μg/mL) was seen in 80 1% of the hospitalized patients D-dimer level ≥2 01 μg/mL was a significant predictor of subsequent deaths (P < 0 01;HR, 3 165;95% CI, 2 013–4 977) The high D-dimer values (≥0 50 μg/mL) were observed in 72 of the 75 (96%) cases with a fatal outcome Median D-dimer values among non-survivors was 6 34 μg/mL and among survivors it was 0 94 μg/mL A higher proportion of fatal outcomes occurred in patients with underlying disease (89 0%), most prominent of which was Diabetes Mellitus (66%) The median D-dimer value was found to be significantly high in Diabetic patients (1 68 μg/mL) Conclusions : Among the measured coagulation parameters, D-dimer during hospital stay had the highest C-index to predict in-hospital mortality in COVID-19 patients D-dimer value ≥ 2 01 μg/mL can effectively predict in-hospital mortality in patients with COVID-19 A significant association of increased D-dimer level has been found with Diabetes Mellitus and elderly age