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Research Paper|Volume 13, Issue 4|pp 4794—4810

Association of D-dimer elevation with inflammation and organ dysfunction in ICU patients with COVID-19 in Wuhan, China: a retrospective observational study

Wang Zhang1, Ling Sang2, Jiaran Shi3, Ming Zhong4, Li Jiang5, Bin Song6, Liang Kang7, Yun Zhang8, Dingyu Zhang9,10, Yunsong Yu1, Xia Zheng8
  • 1Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
  • 2Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, P.R. China
  • 3Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
  • 4Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, P.R. China
  • 5Department of Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China
  • 6Department of Tuberculosis and Respiratory Disease, Jinyintan Hospital, Wuhan, Hubei, P.R. China
  • 7Department of Critical Care Medicine, Jinyintan Hospital, Wuhan, Hubei, P.R. China
  • 8Department of Critical Care Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
  • 9Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Hubei, P.R. China
  • 10Research Center for Translational Medicine, Wuhan Jinyintan Hospital, Hubei, P.R. China
* Equal contribution
Received: August 10, 2020Accepted: December 19, 2020Published: February 11, 2021
https://doi.org/10.18632/aging.202496

Copyright: © 2021 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Coronavirus disease 2019 (COVID-19)-associated coagulation dysfunction is gaining attention. In particular, dynamic changes in the D-dimer level may be related to disease progression. Here, we explored whether elevated D-dimer level was related to multiple organ failure and a higher risk of death. This study included 158 patients with COVID-19 who were admitted to the intensive care unit (ICU) at Jinyintan Hospital in Wuhan, China between January 20, 2020 and February 26, 2020. Clinical and laboratory data were collected. The relationship between D-dimer elevation and organ dysfunction was analyzed, as were dynamic changes in inflammation and lipid metabolism. Approximately 63.9% of patients with COVID-19 had an elevated D-dimer level on ICU admission. The 14 day ICU mortality rate was significantly higher in patients with a high D-dimer level than in those with a normal D-dimer level. Patients with a D-dimer level of 10-40μg/mL had similar organ function on ICU admission to those with a D-dimer level of 1.5–10μg/mL. However, patients with higher levels of D-dimer developed organ injuries within 7 days. Furthermore, significant differences in inflammation and lipid metabolism markers were observed between the two groups. In conclusion, the D-dimer level is closely related to COVID-19 severity and might influence the likelihood of rapid onset of organ injury after admission.