OUTCOMES OF HOSPITALIZED PATIENTS WITH SEVERE COVID-19 PNEUMONIA BASED ON D-DIMER LEVELS

Background: Outcomes for hypoxic patients infected with Coronavirus Disease 2019 (COVID-19) and elevated D-dimer levels are not well understood. The objective of this study was to compare D-dimer levels in COVID-19 patients diagnosed with acute respiratory distress syndrome (ARDS) and non-ARDS and evalaute their outcomes. Methods: Retrospective evalaution of hospitalized patients with COVID-19 pneumonia requiring supplemental oxygen for hypoxia and that had D-dimer levels available on admission. The study period was March 1 to May 31, 2020. Patients were categorized as ARDS and non-ARDS and compared by D-dimer level. Evaluated outcomes included hospital mortality, mechanical ventilation, acute kidney injury, shock, and length of stay. Results: Out of 1242 patients enrolled, 254 presented with ARDS and 988 with nonARDS; 489 (39%) patients had elevated D-dimer levels on admission. Mortality among all patients was 36.6%, higher mortality in the group with elevated D-dimer levels (81% for ARDS versus 35.7% for non-ARDS). Mechanical ventilation, acute kidney injury, thromboembolic events, and shock were more frequently observed in the group with both ARDS and elevated D-dimer levels. Regression analysis revealed a correlation between ARDS, males, old age, asthma, serum creatinine at discharge, and acute kidney injury with increased mortality. Conclusions:This study provides comparative phenotypic characteristics of COVID-19 patients presenting with hypoxia in a high-risk, underrepresented community. Morbidity and mortality can be predicted by using readily available toold like oxygenation and D-dimer levels on admission; this could help to identify patients who will require a higher level of care and potentially could have more COVID-19 related complications.