期刊
HEART & LUNG
卷 50, 期 1, 页码 9-12出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.hrtlng.2020.08.024
关键词
D-dimer; All-cause mortality; ICU admission; ARDS; SARS-CoV-2
This study found through meta-analysis that patients infected with SARS-CoV-2 and elevated D-dimers tended to have worse clinical outcomes including all-cause mortality, ICU admission or ARDS, suggesting that measuring D-dimers can guide clinical decision making.
Aim: To determine if D-dimers are elevated in individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who have adverse clinical outcomes including all-cause mortality, intensive care unit (ICU) admission or acute respiratory distress syndrome (ARDS). Methods: We conducted a systematic review and meta-analysis of the published literature in PubMed, Embase and Cochrane databases through April 9, 2020 for studies evaluating D-dimer levels in SARS-COV-2 infected patients with and without a composite clinical endpoint, defined as the presence of all-cause of mortality, Intensive care unit (ICU) admission or acute respiratory distress syndrome (ARDS). A total of six studies were included in the meta-analysis. Results: D-dimers were significantly increased in patients with the composite clinical end point than in those without (SMD, 1.67 ug/ml (95% CI, 0.72-2.62 ug/ml). The SMD of the studies (Tang et al, Zhou et al, Chen et al), which used only mortality as an outcome measure was 2.5 ug/mL (95% CI, 0.62-4.41 ug/ml). Conclusion: We conclude that SARS-CoV-2 infected patients with elevated D-dimers have worse clinical outcomes (all-cause mortality, ICU admission or ARDS) and thus measurement of D-dimers can guide in clinical decision making. (C) 2020 Published by Elsevier Inc.
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