American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2020, 8(10), 337-340
DOI: 10.12691/ajmcr-8-10-5
Open AccessReview Article

Utility of D-dimer as a Prognostic Factor in SARS CoV2 Infection: A Review

Pramod Theetha Kariyanna1, Lyudmila Aurora1, Apoorva Jayarangaiah2, Vivek Yadav3, Naseem. A. Hossain1, Nasrin Akter1, Moro O. Salifu1 and Isabel M. McFarlane1,

1Department of Internal Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, New York, U.S.A

2Department of Internal Medicine, Albert Einstein College of Medicine, NYC Health and Hospitals/Jacobi Medical Center, Bronx, New York-10461, U.S.A

3Department of Internal Medicine, Brookdale University Hospitals and Medical Center, 1 Brookdale Plaza, Brooklyn, New York- 11212, USA

Pub. Date: June 22, 2020

Cite this paper:
Pramod Theetha Kariyanna, Lyudmila Aurora, Apoorva Jayarangaiah, Vivek Yadav, Naseem. A. Hossain, Nasrin Akter, Moro O. Salifu and Isabel M. McFarlane. Utility of D-dimer as a Prognostic Factor in SARS CoV2 Infection: A Review. American Journal of Medical Case Reports. 2020; 8(10):337-340. doi: 10.12691/ajmcr-8-10-5


Coronavirus Disease-2019 (COVID-19) is currently a public health emergency and has been listed by the World Health Organization (WHO) as a pandemic. It has commonly been associated with pulmonary manifestations and there is a growing body of evidence of multisystem involvement of the virus. As evidenced by various case reports and cohort studies, COVID-19-associated coagulopathy has been a common manifestation amongst the critically ill and has been associated with increased mortality. The presence of venous thromboembolic events in patients who are critically ill due to COVID-19 has prompted the adoption of anticoagulation regimens aimed at preventing thromboembolic phenomena. Coagulation abnormalities have also been implicated in the progression and the severity of COVID-19 related acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). There is strong evidence that D-dimer levels help predict which patients are at risk of thromboembolic events, progression to ARDS, DIC, immune dysregulation and mortality. We will review the utility of D-dimer as screening tool and in the risk stratification of COVID-19 patients prone to developing thromboembolic events, DIC, immune dysregulation and death. To date, the studies that have been published show the presence of elevated D-dimer levels in both the adult and pediatric populations and the measured level correlates with disease severity. Studies have also shown the relative increase of D-dimer levels in non-survivors compared to survivors. The elevation of D-dimer levels has shown to guide clinical decision making, namely the initiation of therapeutic anticoagulation and mortality benefit in patients with severe COVID-19 pneumonia compared to severe non COVID-19 pneumonia. Although the current body of literature suggested the use of D-dimer as a risk stratification tool and as a test to augment clinical judgement regarding the initiation of anticoagulation, randomized control trials are needed to fully understand the relationship between COVID-19 infection and the efficacy of D-dimer assays in clinical decision making.

COVID-19 Corona Virus D-dimer microvascular thrombosis and macrovascular thrombosis

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