D-dimers in omicron versus delta: A retrospective analysis

Alon H Shulman; Barry Jacobson; Bradley M Segal; Amber Khan; Jessica Trusler; Lindsay Earlam; Guy Shemesh

doi:10.4102/sajid.v37i1.484

D-dimers in omicron versus delta: A retrospective analysis

S Afr J Infect Dis. 2022 Nov 30;37(1):484. doi: 10.4102/sajid.v37i1.484. eCollection 2022.

Authors

Alon H Shulman¹, Barry Jacobson^{1

2}, Bradley M Segal¹, Amber Khan¹, Jessica Trusler³, Lindsay Earlam⁴, Guy Shemesh¹

Affiliations

¹ Department of Haematology and Molecular Medicine, Faculty of Health Sciences, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa.
² Department of Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
³ Clinical Pathology Division, Ampath Laboratories, Johannesburg, South Africa.
⁴ Department of Haematology, Lancet Laboratories, Johannesburg, South Africa.

Abstract

Background: Infection with SARS-CoV-2 has shown to cause an increase in D-dimers, which correlate with severity and prognosis for in-hospital mortality. The B.1.617.2 (delta) variant is known to cause a raised D-dimer level, with data on D-dimers in the B.1.1.529 (omicron) variant being scarce.

Objectives: To determine the effect of age, gender and SARS-CoV-2 variant on the D-dimer in South Africans admitted to tertiary medical centres from May 2021 to December 2021.

Method: The study was performed retrospectively on 16 010 adult patients with a SARS-CoV-2 infection. Age, gender, SARS-CoV-2 PCR and D-dimer levels on admission were collected from two national laboratories. Admissions from 01 May 2021 to 31 October 2021 were classified as B.1.617.2, whereas admissions from 01 November 2021 to 23 December 2021 were classified as B.1.1.529 infections.

Results: Omicron infections had a median D-dimer level of 0.54 µg/mL (95% CI: 0.32, 1.08, p < 0.001). Multivariable regression analysis showed that infection with omicron had a 34.30% (95% CI: 28.97, 39.23) reduction in D-dimer values, compared with delta infections. Middle aged, aged and aged over 80 years had D-dimer results greater than the adult baseline (42.6%, 95% CI: 38.0, 47.3, 124.6%, 95% CI: 116.0, 133.7 and 216.1%, 95% CI: 199.5, 233.3). Males on average had a 7.1% (95% CI: 4.6, 9.6) lower D-dimer level than females.

Conclusion: Infection with the B.1.1.529 variant, compared with B.1.617.2 variant, had significantly lower D-dimer levels, with age being a more significant predictor of D-dimer levels, than gender and SARS-CoV-2 variant of infection.

Contribution: This study provides novel insight into the hypercoagulable impact of various SARS-CoV-2 variants, which can guide the management of patients.

Keywords: B.1.1.529; B.1.617.2; D-dimer; SARS-CoV-2; delta; omicron.