A cohort study of 676 patients indicates Ddimer is a critical risk factor for the mortality of COVID-19

Abstract

Coronavirus Disease 2019 (COVID-19) has recently become a public emergency and a worldwide pandemic. However, the information on the risk factors associated with the mortality of COVID-19 and of their prognostic potential is limited. In this retrospective study, the clinical characteristics, treatment and outcome data were collected and analyzed from 676 COVID-19 patients stratified into 140 non-survivors and 536 survivors. We found that the levels of Dimerized plasmin fragment D (D-dimer), C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT) were significantly higher in non-survivals on admission (non-survivors vs. survivors: D-Dimer = 0.5 mg/L, 83.2% vs. 44.9%, P<0.01; CRP =10 mg/L, 50.4% vs. 6.0%, P<0.01; LDH = 250 U/L, 73.8% vs. 20.1%, P<0.01; PCT = 0.5 ng/ ml, 27.7% vs. 1.8%, P<0.01). Moreover, dynamic tracking showed D-dimer kept increasing in non-survivors, while CRP, LDH and PCT remained relatively stable after admission. Ddimer has the highest C-index to predict in-hospital mortality, and patients with D-dimer levels =0.5 mg/L had a higher incidence of mortality (Hazard Ratio: 4.39, P<0.01). Our study suggested D-dimer could be a potent marker to predict the mortality of COVID-19, which may be helpful for the management of patients.