D-dimer levels in non-COVID-19 ARDS and COVID-19 ARDS patients: A systematic review with meta-analysis

PLoS One. 2023 Feb 6;18(2):e0277000. doi: 10.1371/journal.pone.0277000. eCollection 2023.

Abstract

Background: Hypercoagulability and thrombo-inflammation are the main reasons for death in COVID-19 patients. It is unclear whether there is a difference between D-dimer levels in patients without or with COVID-19 acute respiratory distress syndrome (ARDS).

Methods: We searched PubMed, EMBASE, and ClinicalTrails.gov databases looking for studies reporting D-dimer levels in patients without or with COVID-19 ARDS. Secondary endpoints included length of hospital stay, and mortality data at the longest follow-up available.

Results: We included 12 retrospective and 3 prospective studies with overall 2,828 patients, of whom 1,404 (49.6%) had non-COVID-19 ARDS and 1,424 had COVID-19 ARDS. D-dimer levels were not significantly higher in non-COVID-19 ARDS than in COVID-19 ARDS patients (mean 7.65 mg/L vs. mean 6.20 mg/L MD 0.88 [CI: -0.61 to 2.38] p = 0.25; I² = 85%) while the length of hospital stay was shorter (non-COVID-19 mean 37.4 days vs. COVID-19 mean 48.5 days, MD -10.92 [CI: -16.71 to -5.14] p < 0.001; I² = 44%). No difference in mortality was observed: non-COVID-19 ARDS 418/1167 (35.8%) vs. COVID-19 ARDS 467/1201 (38.8%).

Conclusions: We found no difference in the mean D-dimer levels between non-COVID-19 ARDS and COVID-19 ARDS patients.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19* / complications
  • Fibrin Fibrinogen Degradation Products* / analysis
  • Humans
  • Prospective Studies
  • Respiratory Distress Syndrome* / virology
  • Retrospective Studies

Substances

  • fibrin fragment D
  • Fibrin Fibrinogen Degradation Products

Grants and funding

The authors received no specific funding for this work.