ArticleClinics (Sao Paulo, Brazil)2021
Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study.
Article in Clinics (Sao Paulo, Brazil), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- Investigation of Serum Endocan Levels in SARS-CoV-2 Patients.International journal of molecular sciences · 2024Article
- Clinical characteristics of patients hospitalized for COVID-19: comparison between different age groups.BMC geriatrics · 2024Article
- Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic.Frontiers in public health · 2024Article
- Prediction of the risk of mortality in older patients with coronavirus disease 2019 using blood markers and machine learning.Frontiers in immunology · 2024Article
- COVID-19 Complications: Oxidative Stress, Inflammation, and Mitochondrial and Endothelial Dysfunction.International journal of molecular sciences · 2023Review
- Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes.European geriatric medicine · 2023Article
- Immunothrombosis and COVID-19 ‒ a nested post-hoc analysis from a 3186 patient cohort in a Latin American public reference hospital.Clinics (Sao Paulo, Brazil) · 2023Article
- Article
- Elevated Plasma D-Dimer Concentrations in Adults after an Outpatient-Treated COVID-19 Infection.Viruses · 2022Article
- Severity and Mortality Predictors of COVID-19 Patients with Thrombotic Events-Evidence from theVaccines · 2022Article
- Scientific legacy of COVID-19 at the FMUSP-HC academic health system: current status and implications for the future.Clinics (Sao Paulo, Brazil) · 2021Article
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Authors and funding
43 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCoronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19.
methodsData were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations.
resultsBetween March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor.
conclusionD-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.
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