دورية أكاديمية
أعرض في EDS

Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19.

التفاصيل البيبلوغرافية
العنوان: Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19.
المؤلفون: Ali A; Department of laboratory medicine, School of Medicine, Jiangsu University, Zhenjiang, 212013, China.; Department of pulmonary medicine, Abbassia Chest Hospital, MOH, Cairo, Egypt.; Department of respiratory allergy, Al-Rashed Allergy Centre, MOH, Kuwait, Kuwait., Liang W; Department of laboratory medicine, School of Medicine, Jiangsu University, Zhenjiang, 212013, China., Abdelhafiz AS; Department of Clinical Pathology, National Cancer Institute, Cairo University, Kasr Al-Aini Street, from El-Khalig Square, Cairo, 11796, Egypt. ahmed.samir@nci.cu.edu.eg., Saleh MM; Department of chest disease, Faculty of Medicine, Tanta University, Tanta, Egypt., Salem H; Department of chest disease, Faculty of Medicine, Tanta University, Tanta, Egypt., Moazen EM; Department of chest disease, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Elmazny MI; Department of anesthesia, intensive care and pain, Faculty of Medicine, Tanta University, Tanta, Egypt., Rakha MA; Department of chest disease, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Elfeky SEF; Department of chest disease, Faculty of Medicine, Tanta University, Tanta, Egypt.
المصدر: BMC pulmonary medicine [BMC Pulm Med] 2023 Aug 03; Vol. 23 (1), pp. 283. Date of Electronic Publication: 2023 Aug 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968563 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2466 (Electronic) Linking ISSN: 14712466 NLM ISO Abbreviation: BMC Pulm Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001]-
مواضيع طبية MeSH: COVID-19*/therapy, Humans ; Male ; Middle Aged ; Female ; Respiration, Artificial ; SARS-CoV-2 ; Retrospective Studies
مستخلص: Background: Severe COVID-19 disease is typically associated with an urgent need for supplemental oxygen therapy that may be successfully delivered through conventional methods or require invasive mechanical ventilation. Early prediction of the need for invasive mechanical ventilation could significantly improve outcomes of COVID-19 patients. Plasma levels of D-dimer and a number of inflammatory markers as well as values of complete blood counts, all measured in the first two days of hospital admission of COVID-19 patients, were evaluated for their significance as predictors of the eventual need for invasive mechanical ventilation support as well as their values as predictors of post-ventilation morbidly and mortality.
Methods: This retrospective cohort study was conducted at a single center and included data pertaining to 200 patients with previously confirmed moderate to severe COVID-19 disease in the period between May 2021 and the end of December 2022. Data were retrieved from medical records for further analysis.
Results: The mean (SD) age of patients stood at 59 (14) years of age, and with a majority of patients being male (77%). About 18% of cases, all of significantly older age, had been connected to invasive mechanical ventilation (IMV). Total leucocytic count (TLC), as well as levels of urea, creatinine, D-dimer, ferritin, and CRP in IMV patients were significantly higher than non-ventilated patients (p < 0.01 for all). In contrast, lymphocytic count, hemoglobin level, and platelet count were significantly lower in IMV patients (p < 0.001, 0.04, and 0.002, respectively). The mortality rate was significantly higher in IMV patients (p < 0.001). D-dimer independently predicted IMV demand (OR = 1, p = 0.001 in adjusted and unadjusted models). The utility of D-dimer was excellent; and the cutoff level of above 1415 µ/L showed sensitivity and specificity of about 92% and 76%, respectively. Also, the D-dimer level was very effective in predicting post-IMV survival; the AUC = 0.86, p = 0.02, and a cutoff value below 4558 µ/L was associated with 100% and 66% sensitivity and specificity, respectively.
Conclusions: High D-dimer levels independently correlated with the need for invasive mechanical ventilation. Low levels of this marker could evidently predict post-IMV survival of mechanically ventilated COVID-19 patients. Measuring D-dimer levels during routine follow up of those patients would thus be useful in predicting patient outcomes.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
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فهرسة مساهمة: Keywords: D-dimer; Invasive mechanical ventilation; Severe COVID-19
المشرفين على المادة: 0 (fibrin fragment D)
تواريخ الأحداث: Date Created: 20230803 Date Completed: 20230807 Latest Revision: 20231123
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10401731
DOI: 10.1186/s12890-023-02551-z
PMID: 37537520
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2466
DOI:10.1186/s12890-023-02551-z