Evidence map›Paper›PMID 32620118›Full record

ArticleRespiratory research2020

Dynamic changes of D-dimer and neutrophil-lymphocyte count ratio as prognostic biomarkers in COVID-19.

Wenjing Ye, Guoxi Chen, Xiaopan Li, Xing Lan, Chen Ji, Min Hou, Di Zhang, Guangwang Zeng, Yaling Wang, Cheng Xu and 5 more

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Article in Respiratory research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 9 of them syntheses that pooled it.

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92citing papers in PubMed, 9 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  9. Diagnostic Value of D-Dimer in COVID-19: A Meta-Analysis and Meta-Regression.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
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32 more citing papers are in PubMed but not listed here.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Wenjing YeDepartment of Respiratory Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
Guoxi ChenDepartment of Tuberculosis ward 2, Wuhan Pulmonary Hospital, Wuhan, 430030, Hubei, China.
Xiaopan LiCenter for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.
Xing LanDepartment of Tuberculosis ward 2, Wuhan Pulmonary Hospital, Wuhan, 430030, Hubei, China.
Chen JiWarwick Clinical Trials Unit, Warwick Medical School, Coventry, UK.
Min HouSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Di ZhangDepartment of Geriatrics, Xinhua Hospital, School of Medicine, Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200092, China.
Guangwang ZengDepartment of Geriatrics, Xinhua Hospital, School of Medicine, Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200092, China.
Yaling WangDepartment of Tuberculosis ward 2, Wuhan Pulmonary Hospital, Wuhan, 430030, Hubei, China.
Cheng XuDepartment of Geriatrics, Xinhua Hospital, School of Medicine, Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200092, China.
Weiwei LuDepartment of Emergency, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
Ruolin CuiDepartment of Chinese Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
Yuyang CaiSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. caiyuyang@sjtu.edu.cn.
Hai HuangDepartment of Tuberculosis ward 2, Wuhan Pulmonary Hospital, Wuhan, 430030, Hubei, China. 1220775601@qq.com.
Ling YangDepartment of Geriatrics, Xinhua Hospital, School of Medicine, Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200092, China. yangling01@xinhuamed.com.cn.

Funding

Zhejiang University special scientific research fund for COVID-19 prevention and control 2020XGZX065
6 · The paper itself

Abstract

backgroundSince December 2019, the outbreak of COVID-19 caused a large number of hospital admissions in China. Many patients with COVID-19 have symptoms of acute respiratory distress syndrome, even are in danger of death. This is the first study to evaluate dynamic changes of D-Dimer and Neutrophil-Lymphocyte Count Ratio (NLR) as a prognostic utility in patients with COVID-19 for clinical use.

methodsIn a retrospective study, we collected data from 349 hospitalized patients who diagnosed as the infection of the COVID-19 in Wuhan Pulmonary Hospital. We used ROC curves and Cox regression analysis to explore critical value (optimal cut-off point associated with Youden index) and prognostic role of dynamic changes of D-Dimer and NLR.

resultsThree hundred forty-nine participants were enrolled in this study and the mortality rate of the patients with laboratory diagnosed COVID-19 was 14.9%. The initial and peak value of D-Dimer and NLR in deceased patients were higher statistically compared with survivors (P < 0.001). There was a more significant upward trend of D-Dimer and NLR during hospitalization in the deceased patients, initial D-Dimer and NLR were lower than the peak tests (MD) -25.23, 95% CI: - 31.81- -18.64, P < 0.001; (MD) -43.73, 95% CI:-59.28- -31.17, P < 0.001. The test showed a stronger correlation between hospitalization days, PCT and peak D-Dimer than initial D-Dimer. The areas under the ROC curves of peak D-Dimer and peak NLR tests were higher than the initial tests (0.94(95%CI: 0.90-0.98) vs. 0.80 (95% CI: 0.73-0.87); 0.93 (95%CI:0.90-0.96) vs. 0.86 (95%CI:0.82-0.91). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR was 0.73 mg/L, 3.78 mg/L,7.13 and 14.31 respectively. 35 (10.03%) patients were intubated. In the intubated patients, initial and peak D-Dimer and NLR were much higher than non-intubated patients (P < 0.001). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR in prognosticate of intubation was 0.73 mg/L, 12.75 mg/L,7.28 and 27.55. The multivariable Cox regression analysis showed that age (HR 1.04, 95% CI 1.00-1.07, P = 0.01), the peak D-Dimer (HR 1.03, 95% CI 1.01-1.04, P < 0.001) were prognostic factors for COVID-19 patients' death.

conclusionsTo dynamically observe the ratio of D-Dimer and NLR was more valuable during the prognosis of COVID-19. The rising trend in D-Dimer and NLR, or the test results higher than the critical values may indicate a risk of death for participants with COVID-19.

Indexed as

Lymphocyte CountNeutrophilsAdultAgedBiomarkersCohort StudiesCoronavirus InfectionsCOVID-19FemaleFibrin Fibrinogen Degradation ProductsHospitals, SpecialHumansLeukocyte CountMaleMiddle AgedPandemicsBiomarkersFibrin Fibrinogen Degradation Productsfibrin fragment DCOVID-19Cox regressionD-dimerNeutrophil-lymphocyte count ratioPrognostic biomarker

Identifiers

PMID32620118
PMCPMC7332531

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.