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Abstract
Hypercoagulability and the need for prioritizing coagulation markers for prognostic abilities have been highlighted in COVID-19. We aimed to quantify the associations of D-dimer with disease progression in patients with COVID-19. This systematic review and meta-analysis was registered with PROSPERO, CRD42020186661.We included 113 studies in our systematic review, of which 100 records (n = 38,310) with D-dimer data) were considered for meta-analysis. Across 68 unadjusted (n = 26,960) and 39 adjusted studies (n = 15,653) reporting initial D-dimer, a significant association was found in patients with higher D-dimer for the risk of overall disease progression (unadjusted odds ratio (uOR) 3.15; adjusted odds ratio (aOR) 1.64). The time-to-event outcomes were pooled across 19 unadjusted (n = 9743) and 21 adjusted studies (n = 13,287); a strong association was found in patients with higher D-dimers for the risk of overall disease progression (unadjusted hazard ratio (uHR) 1.41; adjusted hazard ratio (aHR) 1.10). The prognostic use of higher D-dimer was found to be promising for predicting overall disease progression (studies 68, area under curve 0.75) in COVID-19. Our study showed that higher D-dimer levels provide prognostic information useful for clinicians to early assess COVID-19 patients at risk for disease progression and mortality outcomes. This study, recommends rapid assessment of D-dimer for predicting adverse outcomes in COVID-19.
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Details
1 All India Institute of Medical Sciences, Department of Biochemistry, Deoghar, India (GRID:grid.413618.9) (ISNI:0000 0004 1767 6103)
2 All India Institute of Medical Sciences, Deoghar, India (GRID:grid.413618.9) (ISNI:0000 0004 1767 6103)
3 All India Institute of Medical Sciences, Department of Respiratory Medicine, Jodhpur, India (GRID:grid.413618.9) (ISNI:0000 0004 1767 6103)
4 ICMR-National Institute of Nutrition, Department of Bioinformatics, Hyderabad, India (GRID:grid.419610.b) (ISNI:0000 0004 0496 9898)
5 Banaras Hindu University, Department of Biochemistry, Institute of Medical Sciences, Varanasi, India (GRID:grid.411507.6) (ISNI:0000 0001 2287 8816)
6 All India Institute of Medical Sciences, Department of Microbiology, Rishikesh, India (GRID:grid.413618.9) (ISNI:0000 0004 1767 6103)