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

被引：37

作者：

Chocron, Richard ^{[1
,2
]}

Duceau, Baptiste ^{[1
,3
]}

Gendron, Nicolas ^{[4
,5
]}

Ezzouhairi, Nacim ^{[6
]}

Khider, Lina ^{[5
,7
]}

Trimaille, Antonin ^{[8
]}

Goudot, Guillaume ^{[5
,7
]}

Weizman, Orianne ^{[9
]}

Alsac, Jean Marc ^{[3
,5
,10
]}

Pommier, Thibault ^{[11
]}

Bory, Olivier ^{[12
]}

Cellier, Joffrey ^{[13
]}

Philippe, Aurelien ^{[4
,5
]}

Geneste, Laura ^{[14
]}

Abdallah, Iannis Ben ^{[3
,5
,10
]}

Panagides, Vassili ^{[15
]}

Batti, Salma El ^{[3
,5
,10
]}

Marsou, Wassima ^{[16
]}

Juvin, Philippe ^{[12
]}

Deney, Antoine ^{[17
]}

Messas, Emmanuel ^{[1
,18
]}

Attou, Sabir ^{[19
]}

Planquette, Benjamin ^{[3
,20
,21
]}

Mika, Delphine ^{[22
]}

Gaussem, Pascale ^{[3
,23
]}

Fauvel, Charles ^{[24
]}

Diehl, Jean-Luc ^{[3
,5
,25
]}

Pezel, Theo ^{[26
]}

Mirault, Tristan ^{[1
,18
]}

Sutter, Willy ^{[1
,3
]}

Sanchez, Olivier ^{[20
,21
]}

Bonnet, Guillaume ^{[1
,3
]}

Cohen, Ariel ^{[27
]}

Smadja, David M. ^{[4
,5
]}

机构：

[1] Univ Paris, INSERM, PARCC, F-75015 Paris, France

[2] Georges Pompidou European Hosp, Emergency Dept, AP HP, F-75015 Paris, France

[3] Univ Paris, Innovat Therapies Haemostasis, INSERM, F-75015 Paris, France

[4] Georges Pompidou European Hosp, Dept Haematol, AH HP, F-75015 Paris, France

[5] Georges Pompidou European Hosp, Biosurg Res Lab, AH HP, Carpentier Fdn, F-75015 Paris, France

[6] Univ Med Bordeaux, Ctr Hosp Univ Bordeaux, F-33076 Bordeaux, France

[7] Univ Paris, Vasc Med Dept, F-75015 Paris, France

[8] Ctr Hosp Reg Univ Strasbourg, Nouvel Hop Civil, F-67000 Strasbourg, France

[9] Ctr Hosp Reg Univ Nancy, F-54511 Vandoeuvre Les Nancy, France

[10] Georges Pompidou European Hosp, Carpentier Fdn, Vasc Surg Dept, AH HP, F-75015 Paris, France

[11] Ctr Hosp Univ Dijon, F-21000 Dijon, France

[12] Univ Paris, Georges Pompidou European Hosp, Emergency Dept, AP HP, F-75015 Paris, France

[13] Univ Paris, Georges Pompidou European Hosp, AP HP, F-75015 Paris, France

[14] Ctr Hosp Hosp Univ Amiens Picardie, F-80000 Amiens, France

[15] Ctr Hosp Univ Marseille, F-13005 Marseille, France

[16] Univ Catholique Lille, Ctr Hosp Univ Lille, F-59000 Lille, France

[17] Ctr Hosp Univ Toulouse, F-31400 Toulouse, France

[18] Georges Pompidou European Hosp, Vasc Med Dept, AP HP, F-75015 Paris, France

[19] Ctr Hosp Univ Caen Normandie, F-14000 Caen, France

[20] Georges Pompidou European Hosp, Carpentier Fdn, Resp Med Dept, F-75015 Paris, France

[21] Georges Pompidou European Hosp, Carpentier Fdn, Biosurg Res Lab, F-75015 Paris, France

[22] Univ Paris Saclay, INSERM, UMR S 1180, F-92296 Chatenay Malabry, France

[23] Georges Pompidou European Hosp, Dept Haematol, AP HP, F-75015 Paris, France

[24] Rouen Univ Hosp, FHU REMOD VHF, F-76000 Rouen, France

[25] Georges Pompidou European Hosp, Intens Care Med Dept, AH HP, F-75015 Paris, France

[26] Univ Paris, Lariboisiere Hosp, AP HP, F-75010 Paris, France

[27] St Antoine Hosp, Dept Cardiol, AP HP, F-75012 Paris, France

来源：

ARCHIVES OF CARDIOVASCULAR DISEASES | 2021年 / 114卷 / 05期

关键词：

COVID-19; D-dimer; Microvascular thrombosis; Pulmonary embolism; Deep venous thrombosis;

D O I：

10.1016/j.acvd.2021.02.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 inhospital mortality in patients hospitalised for COVID-19 in a medical ward, regardless of the occurrence of venous thromboembolism during hospitalisation. (C) 2021 Published by Elsevier Masson SAS.

引用

页码：381 / 393

页数：13

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