D-Dimer as a Predictor of Disease Outcome in Intensive Care SARS-COV-2 Patients: A Retrospective Study

Abstract Background The novel coronavirus, designated SARS-COV-2, has caused a pandemic of respiratory illness termed coronavirus disease 2019 (COVID-19). One of the key issues has been the very high number of patients presenting to hospitals that clearly overwhelms the capacities available, especially the need for critical care support. Therefore, early and effective predictors of clinical outcomes has been urgently needed for risk stratification of COVID-19 patients. Objective To evaluate the value of D-dimer blood levels on intensive care unit (ICU) admission as a predictor of disease severity and mortality in COVID-19 ICU admitted patients. Patients and Methods The current study included the records of 465 patients who were admitted to Ain Shams University isolation hospitals ICU during the time period between 1/1/2021 and 1/6/2021. Results There are many studies that have tried to correlate between D dimer levels and COVID-19 outcome. by comparing these studies we find that the value of D-dimer levels as a predictor of disease outcome is quite obvious. Trying to find opposing literature to the previous findings is a difficult process as the great majority of the literature that tried to link D-dimer levels to COVID -19 outcomes have eventually come to the same conclusion which is proving that there is a significant relationship between D-dimer levels and disease outcome and that morbidity and mortality risk increases with elevated D-dimer levels. Conclusion In COVID-19 patients, D-dimer levels on admission to ICU and 48 hours afterwards can be a reliable indicator of the disease prognosis as high D-dimer levels are associated with increased need for mechanical ventilation and mortality with cutoff values 1.39 for initial D-dimer and 1.02 for D-dimer level after 48 hours.