Abstract
Introduction: Although D-dimer was reported to be elevated in COVID-19
death, few studies about changes in serial D-Dimer Levels with different
severity of illness. Early prophylactic anticoagulation contributes to
improve patient outcomes in COVID-19, the perception of timing of
anticoagulant treatment is mixed. Methods: Retrospective analysis of 38
severity COVID-19 patients, compared changes in serial D-Dimer Levels
between low-flow oxygen therapy and higher concentration oxygen therapy.
Patients were stratified into two groups distinguished by D-Dimer value
in start of anticoagulation treatment, definition D-Dimer=3mg/L of a
cut-off value. Compare the improvement within 7 and 14 days, the time to
the first appearance of improvement with chest CT and the days of
hospital stay between two groups. Results: A total of 38 severe patients
who accept anticoagulant therapy were enrolled into the study from
consecutive 59 confirmed cases. Regression analysis showed that compared
to those D-Dimer≤3mg/L, patients with higher D-Dimer increase the risk
(OR=15.697, P<0.001) to develop to further severe illness. The
difference of patient’s improvement within 14 days (P=0.043) was much
more significant compared to 7 days (P=0.757) in two groups. The days at
the time of CT imaging improvement were 12.1±3.6 days in the D-Dimer≤3,
while 16.2±6.4 days in D-Dimer>3 (p=0.028). The hospital stays in the
two groups were 27 (25.5-30.5) days and 28 (27-36.5) days separately
(p=0.086). Conclusions: D-dimer is available for the evaluation of
illness condition and the timing of anticoagulant therapy in severe
COVID-19, and its role should not be ignored and required further study.