Evaluation of d-dimer as outcome biomarker in COVID-19 acute respiratory distress patients.

IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI:10.1590/S1678-9946202466057
Simone Magalhães Diniz, Vitor Augusto Queiroz Mauad, Caio Cesar Ferreira Fernandes, Marcelo Rodrigues Bacci
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Abstract

Acute respiratory distress syndrome is a significant complication in critical care patients. COVID-19 (C19)-associated severe respiratory failure is related to it, and d-dimer rise predicts a worse outcome. To investigate the association between d-dimer and the severity of this respiratory syndrome, we conducted a study in C19 intubated patients. A retrospective, single-center observational study was conducted with 64 C19 adult intubated patients. Strata of d-dimer results between patients was evaluated using survival analysis. Survival was higher in mild respiratory distress patients. D-dimer showed poor sensitivity and specificity in predicting respiratory failure severity. Risk assessment for death showed a higher prevalence of admission d-dimer results (HR 1.335; 95% CI 0.695-2.564). Our sample confidently represented the medical profile of C19 severe patients. Sepsis development in C19 is associated with the inflammatory storm in respiratory distress syndrome. As the receiver operating curves show, the increase in d-dimer results is consistent with inflammation rather than a prognostic biomarker. As expected, severe respiratory distress patients presented higher mortality. In summary, d-dimer results are not associated with the prognosis of C19 respiratory distress syndrome patients.

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评估作为 COVID-19 急性呼吸窘迫患者预后生物标志物的 d-二聚体。
急性呼吸窘迫综合征是危重症患者的一个重要并发症。与COVID-19(C19)相关的严重呼吸衰竭与此有关,而d-二聚体的升高预示着更差的预后。为了研究 d-二聚体与这种呼吸综合征严重程度之间的关系,我们对 C19 插管患者进行了一项研究。我们对 64 名 C19 插管成人患者进行了一项回顾性单中心观察研究。通过生存分析评估了患者之间的 d-二聚体结果分层。轻度呼吸窘迫患者的存活率更高。在预测呼吸衰竭严重程度方面,D-二聚体的敏感性和特异性均较差。死亡风险评估显示,入院时出现 D-二聚体结果的比例更高(HR 1.335;95% CI 0.695-2.564)。我们的样本能够准确代表 C19 重症患者的医疗特征。C19 中败血症的发生与呼吸窘迫综合征中的炎症风暴有关。正如接收器工作曲线所示,d-二聚体结果的增加与炎症一致,而不是预后生物标志物。正如预期的那样,严重呼吸窘迫患者的死亡率较高。总之,d-二聚体结果与 C19 呼吸窘迫综合征患者的预后无关。
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来源期刊
CiteScore
3.60
自引率
5.30%
发文量
100
审稿时长
6-12 weeks
期刊介绍: The Revista do Instituto de Medicina Tropical de São Paulo (Journal of the São Paulo Institute of Tropical Medicine) is a journal devoted to research on different aspects of tropical infectious diseases. The journal welcomes original work on all infectious diseases, provided that data and results are directly linked to human health. The journal publishes, besides original articles, review articles, case reports, brief communications, and letters to the editor. The journal publishes manuscripts only in English. From 2016 on, the Revista do Instituto de Medicina Tropical de São Paulo (Journal of the São Paulo Institute of Tropical Medicine) is published online only, maintaining the free access. For more information visit: - http://www.scielo.br/rimtsp - http://www.imt.usp.br/revista-imt/
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