D-Dimer Levels as a Predictive Marker of Pulmonary Embolism in COVID-19 Patients

Abstract

Background: COVID-19 infections have a higher risk of thrombotic complications due to a pro-inflammatory environment. This study aimed to find the association of D-dimer levels with pulmonary embolism (PE) and assess D-dimer levels as a predictive marker of PE in COVID-19 patients. Methods: This prospective cross-sectional study was conducted from June to December 2021, at a private tertiary care teaching hospital in Karachi. Hospitalized COVID-19 patients with CTPA for PE, aged ≥18 years were selected through purposive sampling. With SPSS v.21, the association of co-morbidities and D-dimer levels for pulmonary embolism was analyzed using a t-test, chi-square test, and regression analysis while the predictive value of D-dimer levels for pulmonary embolism was analyzed using ROC analysis. Results: Participants (337), median age:50yrs, IQR:48-70(52.2% males, 47.8% females). The majority (96.7%) were receiving prophylactic anticoagulant therapy, Median D-dimer levels were 1380(IQR:800-2100). Pulmonary Embolism was found in 46(13.6%), had a significant association with disease duration >5days (p=0.01), D-dimer levels >2200(p2285ng/ml have 80% diagnostic accuracy for pulmonary embolism. Larger multicentre studies are warranted to explore thrombo-prophylaxis indications, drug choice, and dosing based on D-dimer levels. Keywords: COVID-19, Thromboembolism, Pulmonary, D-dimer

Keywords

• Coronavirus Disease 2019, Thromboembolisms, Pulmonary, D-dimer.