Raised D-Dimer Linked to Mortality in Black Individuals With COVID-19 Pneumonia

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. The meeting is being held October 17 to 20, both live in Orlando, FL, and virtually.

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 (less than 2000 ng/mL), moderate (2000 to 3000 ng/mL), and severe (greater than 3000 ng/mL) groups. An elevated D-dimer was characterized by a laboratory-specific upper limit of normal (greater than 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.”

Reference

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.

This article originally appeared on Pulmonology Advisor