Resource: Utility of D-dimer in predicting venous thromboembolism in non-mechanically ventilated COVID survivors
Source: Thrombosis Research
Synopsis: Although D-dimer has been found to be a prognostic factor for VTE in severely-ill ventilated COVID patients, less is known about its utility in those with a non-severe course. This single center retrospective study from an NYC teaching hospital used logistic regression to examine the association between admission d-Dimer levels and VTE diagnosis either during admission or within 14 days after discharge in 2630 mild-moderate COVID-19 patients. Patients with subsequent VTE were more likely to be male, and have a higher baseline WBC.
Admission D-dimer > 5 ug/mL occurred in 11.6% of the study group, and had a 10.7 x baseline odds ratio of VTE, p<0.001.
Although not statistically significant, D-dimer levels between 1-2 ug / mL also increased the odds of VTE to 2.3 x baseline (p=0.1) and those between 2-5 ug/mL to 2.9 x baseline (p=0.06). D-dimer appeared to have utility in predicting VTE risk in acute COVID, even in milder cases. Increased levels correlated with increased VTE risk in this study.
Comment: Although recently published reports have suggested using D-dimer as part of a comprehensive preoperative workup prior to subsequent elective surgery in long-term COVID-19 survivors, we do not yet have hard data. It does seem a reasonable precaution to include this test in those scheduled for major procedures under general anesthesia, if their prior COVID-19 case was significant enough to require hospitalization, and to have a discussion with a local hematologist in the event of an abnormal result.
