Harmonized D-dimer levels upon admission for prognosis of COVID-19 severity: Results from a Spanish multicenter registry (BIOCOVID-Spain study)

被引：21

作者：

Garcia de Guadiana-Romualdo, Luis ^{[1
]}

Morell-Garcia, Daniel ^{[2
]}

Favaloro, Emmanuel J. ^{[3
]}

Vilchez, Juan A. ^{[4
]}

Bauca, Josep M. ^{[2
]}

Alcaide Martin, Maria J. ^{[5
]}

Gutierrez Garcia, Irene ^{[6
]}

de la Hera Cagigal, Patricia ^{[7
]}

Manuel Egea-Caparros, Jose ^{[8
]}

Perez Sanmartin, Sonia ^{[9
]}

Gutierrez Revilla, Jose, I ^{[10
]}

Urrechaga, Eloisa ^{[11
]}

Alamo, Jose M. ^{[12
]}

Hernando Holgado, Ana M. ^{[13
]}

Lorenzo-Lozano, Maria-Carmen ^{[14
]}

Canalda Campas, Magdalena ^{[15
]}

Juncos Tobarra, Maria A. ^{[16
]}

Morales-Indiano, Cristian ^{[17
]}

Virseda Chamorro, Isabel ^{[18
]}

Pastor Murcia, Yolanda ^{[19
]}

Sahuquillo Frias, Laura ^{[20
]}

Altimira Queral, Laura ^{[21
]}

Nuez-Zaragoza, Elisa ^{[22
]}

Ruiz de Leon, Juan Adell ^{[23
]}

Ruiz Ripa, Alicia ^{[24
]}

Salas Gomez-Pablos, Paloma ^{[25
]}

Cebreiros Lopez, Iria ^{[26
]}

Fernandez Uriarte, Amaia ^{[27
]}

Larruzea, Alex ^{[28
]}

Lopez Yepes, Maria L. ^{[29
]}

Sancho-Rodriguez, Natalia ^{[30
]}

Zamorano Andres, Maria C. ^{[31
]}

Pedregosa Diaz, Jose ^{[32
]}

Saenz, Luis ^{[33
]}

Esparza del Valle, Clara ^{[9
]}

Baamonde Calzada, Maria C. ^{[10
]}

Garcia Munoz, Sara ^{[7
]}

Vera, Marina ^{[12
]}

Martin Torres, Esther ^{[14
]}

Sanchez Fdez-Pacheco, Silvia ^{[15
]}

Vicente Gutierrez, Luis ^{[16
]}

Jimenez Anon, Laura ^{[17
]}

Perez Martinez, Alfonso ^{[4
]}

Pons Castillo, Aurelio ^{[18
]}

Gonzalez Tamayo, Ruth ^{[6
]}

Ferriz Vivancos, Jorge ^{[19
]}

Rodriguez-Fraga, Olaia ^{[5
]}

Diaz-Brito, Vicens ^{[34
]}

Aguadero, Vicente ^{[22
]}

Garcia Arevalo, M. G. ^{[23
]}

机构：

[1] Hosp Univ Santa Lucia, Lab Med Dept, C Mezquita,S-N, Cartagena 30202, Spain

[2] Hosp Univ Son Espases, Lab Med Dept, Palma De Mallorca, Spain

[3] Westmead Hosp, Sydney Ctr Thrombosis & Haemostasis, Inst Clin Pathol & Med Res ICPMR, NSW Hlth Pathol,Haematol Sydney Ctr Thrombosis &, Westmead, NSW, Australia

[4] Hosp Univ Morales Meseguer, Lab Med Dept, Murcia, Spain

[5] Hosp Univ La Paz, Lab Med Dept, Madrid, Spain

[6] Hosp Univ Torrevieja, Lab Med Dept, Torrevieja, Spain

[7] Hosp Univ Basurto, Lab Med Dept, Bilbao, Spain

[8] Hosp Univ Los Arcos Mar Menor, Lab Med Dept, San Javier, Spain

[9] Hosp Univ Marques Valdecilla, Lab Med Dept, Santander, Spain

[10] Hosp Sierrallana, Dept Clin Biochem, Torrelavega, Spain

[11] Biocruces Bizkaia Hlth Res Inst, Baracaldo, Spain

[12] Hosp Marina Baixa, Biochem Lab, Villajoyosa, Spain

[13] Hosp Univ Vinalopo, Lab Med Dept, Elche, Spain

[14] Complejo Hosp Toledo, Lab Med Dept, Toledo, Spain

[15] Hosp Cent La Def Gomez Ulla, Lab Med Dept, Madrid, Spain

[16] Complejo Hosp Univ Albacete, Lab Med Dept, Albacete, Spain

[17] Hosp Badalona Germans Trias & Pujol, Lab Med Dept, Barcelona, Spain

[18] Hosp Arnau Vilanova, Lab Med Dept, Valencia, Spain

[19] Consorci Hosp Gen Univ Valencia, Lab Med Dept, Valencia, Spain

[20] Hosp Can Misses, Lab Med Dept, Ibiza, Spain

[21] Parc Sanitari St Joan de Deu, Lab Med Dept, Sant Boi De Llobregat, Spain

[22] Hosp Univ Parc Tauli, Clin Lab Dept, Sabadell, Spain

[23] Hosp Univ Virgen La Victoria, Lab Med Dept, Malaga, Spain

[24] Hosp Mataro, Lab Med Dept, Lab Referencia Catalunya, Mataro, Spain

[25] Consorci Sanitari Terrassa, Catlab, Terrassa, Spain

[26] Hosp Univ Virgen La Arrixaca, Lab Med Dept, Murcia, Spain

[27] Hosp Univ Mania Terrassa, Catlab, Barcelona, Spain

[28] Hosp Fundacio Sanitaria Hosp Mollet, Lab Med Dept, Barcelona, Spain

[29] Hosp Virgen del Castillo, Lab Med Dept, Yecla, Spain

[30] Hosp Gen Univ Reina Sofia, Lab Med Dept, Murcia, Spain

[31] Hosp La Vega Lorenzo Guirao, Lab Med Dept, Cieza, Spain

[32] Hosp Verge La Cinta, Lab Med Dept, Tortosa, Spain

[33] Hosp Gen Univ Rafael Mendez, Lab Med Dept, Lorca, Spain

[34] Parc Sanitari St Joan de Deu, Internal Med Dept, Sant Boi De Llobregat, Spain

[35] Soc Espanola Med Lab SEQC ML, Comis Magnitudes Biol Relacionadas Con La Urgenci, Barcelona, Spain

来源：

JOURNAL OF THROMBOSIS AND THROMBOLYSIS | 2022年 / 53卷 / 01期

关键词：

COVID-19; D-dimer; Harmonization; Prognosis; Mortality; COAGULOPATHY;

D O I：

10.1007/s11239-021-02527-y

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Coagulopathy is a key feature of COVID-19 and D-dimer has been reported as a predictor of severity. However, because D-dimer test results vary considerably among assays, resolving harmonization issues is fundamental to translate findings into clinical practice. In this retrospective multicenter study (BIOCOVID study), we aimed to analyze the value of harmonized D-dimer levels upon admission for the prediction of in-hospital mortality in COVID-19 patients. All-cause in-hospital mortality was defined as endpoint. For harmonization of D-dimer levels, we designed a model based on the transformation of method-specific regression lines to a reference regression line. The ability of D-dimer for prediction of death was explored by receiver operating characteristic curves analysis and the association with the endpoint by Cox regression analysis. Study population included 2663 patients. In-hospital mortality rate was 14.3%. Harmonized D-dimer upon admission yielded an area under the curve of 0.66, with an optimal cut-off value of 0.945 mg/L FEU. Patients with harmonized D-dimer >= 0.945 mg/L FEU had a higher mortality rate (22.4% vs. 9.2%; p < 0.001). D-dimer was an independent predictor of in-hospital mortality, with an adjusted hazard ratio of 1.709. This is the first study in which a harmonization approach was performed to assure comparability of D-dimer levels measured by different assays. Elevated D-dimer levels upon admission were associated with a greater risk of in-hospital mortality among COVID-19 patients, but had limited performance as prognostic test.

引用

页码：103 / 112

页数：10

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