PROGNOSTIC CAPACITY OF D-DIMER IN PREDICTING MORTALITY IN PATIENTS DIAGNOSED WITH COVID-19

Alburqueque-Melgarejo J.; Cuyutupac I.A.G.; Roque-Quezada J.C.E.; Flores H.M.V.; Coronado M.E.A.; Cordova L.E.N. · Revista de la Facultad de Medicina Humana (2024) · DOI: 10.25176/rfmh.v24i2.6558

Resumen

Introduction: SARS-CoV-2 infection can increase the risk of thrombosis. Studies associate D-dimer levels with COVID-19 mortality. Objective: To determine the prognostic capacity of D-dimer in predicting COVID-19 mortality in patients hospitalized in the Intensive Care Unit. Methods: A retrospective cohort study was conducted at the Naval Medical Center from January to July 2021. A total of 324 adult patients with RT-PCR confirmed COVID-19 were included. D-dimer levels were measured upon admission using coagulation turbidimetry (Sysmex CS-5100). Sociodemographic variables, comorbidities, and clinical data were analyzed. Statistical analysis was performed using SPSS version 26, employing Chi-square tests, Fisher's exact test, Mann-Whitney U test, ROC, and Cox regression. Results: A cut-off point of 1.40 µg/mL for D-dimer values was determined, with a sensitivity of 80.9%, specificity of 86.4%, and an area under the curve (AUC) of 0.916 (95% CI: 0.884 – 0.947; p=0.016) for predicting COVID-19 mortality. Additionally, patients with D-dimer values greater than or equal to 1.40 µg/mL had an increased risk of death (adjusted HR = 6.545; 95% CI: 3.867 – 11.077; p<0.001), independent of age, diabetes mellitus, arterial hypertension, ischemic heart disease, cerebrovascular disease, atrial fibrillation, chronic obstructive pulmonary disease, asthma, cancer, and thrombocytopenia. Conclusion: This study showed that admission D-dimer levels represent a reliable biomarker in evaluating the prognosis of COVID-19 patients.

Instituciones: Universidad Científica del Sur; Universidad Privada San Juan Bautista