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D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study
BACKGROUND: Coronavirus disease 2019 (COVID-19) has been associated with coagulation disorders, in particular high concentrations of D-dimer, and increased frequency of venous thromboembolism. AIM: To explore the association between D-dimer at admission and in-hospital mortality in patients hospital...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Published by Elsevier Masson SAS.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7942155/ https://www.ncbi.nlm.nih.gov/pubmed/33846096 http://dx.doi.org/10.1016/j.acvd.2021.02.003 |
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author | Chocron, Richard Duceau, Baptiste Gendron, Nicolas Ezzouhairi, Nacim Khider, Lina Trimaille, Antonin Goudot, Guillaume Weizman, Orianne Alsac, Jean Marc Pommier, Thibault Bory, Olivier Cellier, Joffrey Philippe, Aurélien Geneste, Laura Ben Abdallah, Iannis Panagides, Vassili El Batti, Salma Marsou, Wassima Juvin, Philippe Deney, Antoine Messas, Emmanuel Attou, Sabir Planquette, Benjamin Mika, Delphine Gaussem, Pascale Fauvel, Charles Diehl, Jean-Luc Pezel, Theo Mirault, Tristan Sutter, Willy Sanchez, Olivier Bonnet, Guillaume Cohen, Ariel Smadja, David M. |
author_facet | Chocron, Richard Duceau, Baptiste Gendron, Nicolas Ezzouhairi, Nacim Khider, Lina Trimaille, Antonin Goudot, Guillaume Weizman, Orianne Alsac, Jean Marc Pommier, Thibault Bory, Olivier Cellier, Joffrey Philippe, Aurélien Geneste, Laura Ben Abdallah, Iannis Panagides, Vassili El Batti, Salma Marsou, Wassima Juvin, Philippe Deney, Antoine Messas, Emmanuel Attou, Sabir Planquette, Benjamin Mika, Delphine Gaussem, Pascale Fauvel, Charles Diehl, Jean-Luc Pezel, Theo Mirault, Tristan Sutter, Willy Sanchez, Olivier Bonnet, Guillaume Cohen, Ariel Smadja, David M. |
author_sort | Chocron, Richard |
collection | PubMed |
description | BACKGROUND: Coronavirus disease 2019 (COVID-19) has been associated with coagulation disorders, in particular high concentrations of D-dimer, and increased frequency of venous thromboembolism. AIM: To explore the association between D-dimer at admission and in-hospital mortality in patients hospitalised for COVID-19, with or without symptomatic venous thromboembolism. METHODS: From 26 February to 20 April 2020, D-dimer concentration at admission and outcomes (in-hospital mortality and venous thromboembolism) of patients hospitalised for COVID-19 in medical wards were retrospectively analysed in a multicenter study in 24 French hospitals. RESULTS: Among 2878 patients enrolled in the study, 1154 (40.1%) patients had D-dimer measurement at admission. Receiver operating characteristic curve analysis identified a D-dimer concentration > 1128 ng/mL as the best cut-off value for in-hospital mortality (area under the curve 64.9%, 95% confidence interval [CI] 60–69), with a sensitivity of 71.1% (95% CI 62–78) and a specificity of 55.6% (95% CI 52–58), which did not differ in the subgroup of patients with venous thromboembolism during hospitalisation. Among 545 (47.2%) patients with D-dimer concentration > 1128 ng/mL at admission, 86 (15.8%) deaths occurred during hospitalisation. After adjustment, in Cox proportional hazards and logistic regression models, D-dimer concentration > 1128 ng/mL at admission was also associated with a worse prognosis, with an odds ratio of 3.07 (95% CI 2.05–4.69; P < 0.001) and an adjusted hazard ratio of 2.11 (95% CI 1.31–3.4; P < 0.01). CONCLUSIONS: D-dimer concentration > 1128 ng/mL is a relevant predictive factor for in-hospital mortality in patients hospitalised for COVID-19 in a medical ward, regardless of the occurrence of venous thromboembolism during hospitalisation. |
format | Online Article Text |
id | pubmed-7942155 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Published by Elsevier Masson SAS. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79421552021-03-11 D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study Chocron, Richard Duceau, Baptiste Gendron, Nicolas Ezzouhairi, Nacim Khider, Lina Trimaille, Antonin Goudot, Guillaume Weizman, Orianne Alsac, Jean Marc Pommier, Thibault Bory, Olivier Cellier, Joffrey Philippe, Aurélien Geneste, Laura Ben Abdallah, Iannis Panagides, Vassili El Batti, Salma Marsou, Wassima Juvin, Philippe Deney, Antoine Messas, Emmanuel Attou, Sabir Planquette, Benjamin Mika, Delphine Gaussem, Pascale Fauvel, Charles Diehl, Jean-Luc Pezel, Theo Mirault, Tristan Sutter, Willy Sanchez, Olivier Bonnet, Guillaume Cohen, Ariel Smadja, David M. Arch Cardiovasc Dis Clinical Research BACKGROUND: Coronavirus disease 2019 (COVID-19) has been associated with coagulation disorders, in particular high concentrations of D-dimer, and increased frequency of venous thromboembolism. AIM: To explore the association between D-dimer at admission and in-hospital mortality in patients hospitalised for COVID-19, with or without symptomatic venous thromboembolism. METHODS: From 26 February to 20 April 2020, D-dimer concentration at admission and outcomes (in-hospital mortality and venous thromboembolism) of patients hospitalised for COVID-19 in medical wards were retrospectively analysed in a multicenter study in 24 French hospitals. RESULTS: Among 2878 patients enrolled in the study, 1154 (40.1%) patients had D-dimer measurement at admission. Receiver operating characteristic curve analysis identified a D-dimer concentration > 1128 ng/mL as the best cut-off value for in-hospital mortality (area under the curve 64.9%, 95% confidence interval [CI] 60–69), with a sensitivity of 71.1% (95% CI 62–78) and a specificity of 55.6% (95% CI 52–58), which did not differ in the subgroup of patients with venous thromboembolism during hospitalisation. Among 545 (47.2%) patients with D-dimer concentration > 1128 ng/mL at admission, 86 (15.8%) deaths occurred during hospitalisation. After adjustment, in Cox proportional hazards and logistic regression models, D-dimer concentration > 1128 ng/mL at admission was also associated with a worse prognosis, with an odds ratio of 3.07 (95% CI 2.05–4.69; P < 0.001) and an adjusted hazard ratio of 2.11 (95% CI 1.31–3.4; P < 0.01). CONCLUSIONS: D-dimer concentration > 1128 ng/mL is a relevant predictive factor for in-hospital mortality in patients hospitalised for COVID-19 in a medical ward, regardless of the occurrence of venous thromboembolism during hospitalisation. Published by Elsevier Masson SAS. 2021-05 2021-03-09 /pmc/articles/PMC7942155/ /pubmed/33846096 http://dx.doi.org/10.1016/j.acvd.2021.02.003 Text en © 2021 Published by Elsevier Masson SAS. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Clinical Research Chocron, Richard Duceau, Baptiste Gendron, Nicolas Ezzouhairi, Nacim Khider, Lina Trimaille, Antonin Goudot, Guillaume Weizman, Orianne Alsac, Jean Marc Pommier, Thibault Bory, Olivier Cellier, Joffrey Philippe, Aurélien Geneste, Laura Ben Abdallah, Iannis Panagides, Vassili El Batti, Salma Marsou, Wassima Juvin, Philippe Deney, Antoine Messas, Emmanuel Attou, Sabir Planquette, Benjamin Mika, Delphine Gaussem, Pascale Fauvel, Charles Diehl, Jean-Luc Pezel, Theo Mirault, Tristan Sutter, Willy Sanchez, Olivier Bonnet, Guillaume Cohen, Ariel Smadja, David M. D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study |
title | D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study |
title_full | D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study |
title_fullStr | D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study |
title_full_unstemmed | D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study |
title_short | D-dimer at hospital admission for COVID-19 are associated with in-hospital mortality, independent of venous thromboembolism: Insights from a French multicenter cohort study |
title_sort | d-dimer at hospital admission for covid-19 are associated with in-hospital mortality, independent of venous thromboembolism: insights from a french multicenter cohort study |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7942155/ https://www.ncbi.nlm.nih.gov/pubmed/33846096 http://dx.doi.org/10.1016/j.acvd.2021.02.003 |
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