Correlation Between Thrombotic Parameter D-Dimer and Disease Severity in Patients Infected With SARS-CoV-2 in Da Nang City, Vietnam

Background: The COVID-19 pandemic posed a significant healthcare crisis due to the emergence of acute respiratory infections, leading to severe complications such as thrombosis. Meanwhile, the D-dimer index serves as a dependable routine diagnostic marker for thrombosis. Therefore, it is hypothesized that D-dimer could serve as a potential prognostic marker for COVID-19 infection. Objective: To assess the association between D-dimer levels and the severity of COVID-19 among patients in the Vietnamese central coastal region. Methods: A retrospective cross-sectional study was conducted at Da Nang Hospital for Pulmonary Diseases and its satellites on patients admitted for COVID-19 from September 2021 to April 2022. Clinical data were analyzed using the chi-square test. The receiver operating characteristic (ROC) curve was used to determine the best cut-off for D-dimer levels that differentiate between mild and severe cases amongst COVID-19 positive patients. Results: This study comprised of 205 confirmed COVID-19 patients (mean [SD] age, 66.71 [18.80] years). The participants were divided into 2 groups based on their D-dimer levels: those with D-dimer levels greater than 500 µg/L or less than 500 µg/L. The median D-dimer level of each group were 1507.50 µg/L and 302 µg/L, respectively. Patient age and a history of diabetes correlated with D-dimer elevation in COVID-19 patients. The ROC curve indicated that D-dimer of greater than 638 µg/L was associated with severe disease (sensitivity 80%, specificity 90.8%, area under the curve [AUC] = 0.900). Conclusions: Elevated D-dimer levels was associated with more severe instances of COVID-19 with levels exceeding 638 µg/L demonstrating high sensitivity and specificity.