Evidence map›Paper›PMID 32853982›Full record

ArticleThrombosis research2020

Admission D-dimer levels, D-dimer trends, and outcomes in COVID-19.

Leonard Naymagon, Nicole Zubizarreta, Jonathan Feld, Maaike van Gerwen, Mathilda Alsen, Santiago Thibaud, Alaina Kessler, Sangeetha Venugopal, Iman Makki, Qian Qin and 9 more

Open access · bronzeAbstract read
In one paragraph

Article in Thrombosis research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 4 pooled it
2.8field-weighted citation impact, top 6% of its field
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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 4 syntheses or guidelines pooled it, 129 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  4. 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
    Pooled it
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  20. Observational

3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

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

19 authors at 1 institution in 1 country.

Leonard NaymagonDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America. Electronic address: leonard.naymagon@mountsinai.org.
Nicole ZubizarretaDepartment of Population Health Science and Policy, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Jonathan FeldDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Maaike van GerwenDepartment of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, United States of America; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, United States of America.
Mathilda AlsenDepartment of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, United States of America.
Santiago ThibaudDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Alaina KesslerDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Sangeetha VenugopalDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Iman MakkiDepartment of Medicine, Icahn School of Medicine at Mount Sinai, United States of America.
Qian QinDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Sirish DharmapuriDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Tomi JunDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Sheena BhallaDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Shana BerwickDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Krina ChristianDepartment of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, United States of America.
John MascarenhasDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Francine DembitzerDepartment of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, United States of America.
Erin MoshierDepartment of Population Health Science and Policy, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Douglas TremblayDivision of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States of America.
Icahn School of Medicine at Mount Sinai · US

Funding

THE TISCH CANCER INSTITUTE - CANCER CENTER SUPPORT GRANTP30CA196521 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Ramon E Parsons · 2015 to 2026
$35.4M
NCI NIH HHS P30 CA196521
6 · The paper itself

Abstract

Observational data suggest an acquired prothrombotic state may contribute to the pathophysiology of COVID-19. These data include elevated D-dimers observed among many COVID-19 patients. We present a retrospective analysis of admission D-dimer, and D-dimer trends, among 1065 adult hospitalized COVID-19 patients, across 6 New York Hospitals. The primary outcome was all-cause mortality. Secondary outcomes were intubation and venous thromboembolism (VTE). Three-hundred-thirteen patients (29.4%) died, 319 (30.0%) required intubation, and 30 (2.8%) had diagnosed VTE. Using Cox proportional-hazard modeling, each 1 μg/ml increase in admission D-dimer level was associated with a hazard ratio (HR) of 1.06 (95%CI 1.04-1.08, p < 0.0001) for death, 1.08 (95%CI 1.06-1.10, p < 0.0001) for intubation, and 1.08 (95%CI 1.03-1.13, p = 0.0087) for VTE. Time-dependent receiver-operator-curves for admission D-dimer as a predictor of death, intubation, and VTE yielded areas-under-the-curve of 0.694, 0.621, and 0.565 respectively. Joint-latent-class-modeling identified distinct groups of patients with respect to D-dimer trend. Patients with stable D-dimer trajectories had HRs of 0.29 (95%CI 0.17-0.49, p < 0.0001) and 0.22 (95%CI 0.10-0.45, p = 0.0001) relative to those with increasing D-dimer trajectories, for the outcomes death and intubation respectively. Patients with low-increasing D-dimer trajectories had a multivariable HR for VTE of 0.18 (95%CI 0.05-0.68, p = 0.0117) relative to those with high-decreasing D-dimer trajectories. Time-dependent receiver-operator-curves for D-dimer trend as a predictor of death, intubation, and VTE yielded areas-under-the-curve of 0.678, 0.699, and 0.722 respectively. Although admission D-dimer levels, and D-dimer trends, are associated with outcomes in COVID-19, they have limited performance characteristics as prognostic tests.

Indexed as

SARS-CoV-2AgedCOVID-19FemaleFibrin Fibrinogen Degradation ProductsHumansMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesVenous ThromboembolismFibrin Fibrinogen Degradation Productsfibrin fragment DAdmissionCOVID-19D-dimerOutcomesThrombosisTrend

Identifiers

PMID32853982
PMCPMC7439969
OpenAlexW3070211383

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.