AUTHOR=Li Yayun , Deng Yuhao , Ye Lin , Sun Huiyan , Du Songtao , Huang Huining , Zeng Furong , Chen Xiang , Deng Guangtong 

TITLE=Clinical Significance of Plasma D-Dimer in COVID-19 Mortality

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.638097

DOI=10.3389/fmed.2021.638097

ISSN=2296-858X

ABSTRACT=It is not clear whether D-dimer can be an independent predictor of coronavirus disease 2019 (COVID-19) mortality, and the cut-off of D-dimer for clinical use remains to be determined. Therefore, a comprehensive analysis is still necessary to illuminate the clinical significance of plasma D-dimer in COVID-19 mortality. We searched PubMed, Embase, Cochrane Library and Scopus databases until November, 2020. STATA software was used for all the statistical analyses. The identifier of systematic review registration was PROSPERO CRD42020220927. A total of 66 studies involving 40614 COVID-19 patients were included in our meta-analysis. Pooled data showed that patients in high D-dimer group had poor prognosis than those in low D-dimer group (OR = 4.52, 95% CI = [3.61, 5.67], P < 0.001; HR = 2.81, 95% CI = [1.85, 4.27], P < 0.001). Sensitivity analysis, pooled data based on different effect models and the Duval and Tweedie trim-and-fill method did not change the conclusions. Subgroup analyses stratified by different countries, cutoffs, sample size, study type and analysis of OR/HR still keep consistent conclusions. D-dimer was identified as an independent predictor for COVID-19 mortality. A series of values including 0.5μg/mL, 1μg/mL and 2μg/mL could be determined as cutoff of D-dimer for clinic use. Measurement and monitoring of D-dimer might assist clinicians to take immediate medical actions and predict the prognosis of COVID-19.