The following article is a part of conference coverage from CHEST 2021, being held virtually from October 17 to October 20, 2021. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from CHEST 2021.
Elevated D-dimer was significantly associated with in-hospital mortality among Black individuals with COVID-19 pneumonia, according to a poster presentation for the CHEST 2021 Annual Meeting, held virtually October 17 to 20.
In the retrospective study, a small team of researchers examined disease severity with D-dimer as a surrogate marker in 137 non-Hispanic Black patients with COVID-19 pneumonia who were admitted to a single community hospital in New York City between March and April 2020. Patient data were obtained from electronic medical records.
D-dimer levels were stratified into mild (<2000 ng/mL), moderate (2000-3000 ng/mL), and severe (>3000 ng/mL) groups. An elevated D-dimer was characterized by a laboratory-specific upper limit of normal (>243 ng/mL). The investigators examined differences between patients who died vs those who survived. Additionally, the researchers compared patients with severe and non-severe disease, with intensive care unit (ICU) admission used to categorize severity.
The median length of stay among the patients positive for COVID-19 was 8 days. Approximately 5.9% of patients died on admission, while 33.33% of patients died over the observational study period. While patients who died had a higher mean age compared with those who didn’t die, this difference was not significant (68.77±15.33 years vs 63.87±12.93 years, respectively; P =.07).
Patients who died were significantly more likely to be admitted to the ICU (54.72% vs 19.51%; P <.001) and/or were intubated (49.05% vs 12.20%; P <.001).
There was no significant differences in the odds of mortality among patients with severe D-dimer levels vs mild D-dimer levels (odds ratio [OR], 0.53, 95% CI: 0.25-1.10). In contrast, the researchers observed significantly higher levels of D-dimer in patients who died vs patients who survived (16,912 ng/ml vs 12,892 ng/ml, respectively; P =.004).
The investigators concluded that given “D-dimer is closely related to mortality” in patients with COVID-19, levels of D-dimer “should therefore be closely monitored among in-hospital patients.”
Omore I, Brimah I, Shah J, Ayinla R. D-dimer as a surrogate marker of disease severity in African American population with COVID-19 pneumonia: A community hospital retrospective study. Presented at: CHEST 2021; October 17-20, 2021; Orlando, FL/Virtual. Abstract A519.