D-dimer level and lymphocyte to white blood cell count ratio could be a predictor of mechanical ventilation therapy in patients with coronavirus disease 2019

Some symptomatic patients with coronavirus disease 2019 (COVID-19) develop acute respiratory failure with mechanical ventilation support. Therefore, identifying patients who tend to experience respiratory deterioration is of great importance. We investigated blood markers upon hospital admission that could predict respiratory illness in patients with COVID-19. This retrospective observational study included 148 patients with COVID-19 admitted to our hospital. All blood marker levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, white blood cells (WBCs), and lymphocytes were measured on admission in 148 patients. Patients were divided into the severe group (SVG), requiring mechanical ventilation therapy, and the non-severe group (nSVG). The levels of CRP, LDH, D-dimer and WBC count were significantly higher, and the lymphocyte count and lymphocyte-to-WBC count ratio (LWR) were significantly lower in the SVG than in the nSVG. The area under the receiver operating characteristic curve for CRP, LDH, D-dimer and LWR showed high values of 0.69, 0.70, 0.70, and 0.74, respectively. The age-adjusted odds ratios of D-dimer and LWR were high (5.5 [1.9–15.9] and 5.6 [2.2–14.3], respectively). D-dimer level and LWR upon admission were highly predictive of mechanical ventilation support in patients with COVID-19. © Japanese Society of Biorheology 2022.