• Mert Ozen, Atakan Yilmaz, Vefa Cakmak, Resad Beyoglu, Alten Oskay, Murat Seyit, and Hande Senol.
• Pamukkale University, Medical Faculty, Department of Emergency Medicine, 20070 Denizli, Turkey.
• Am J Emerg Med. 2021 Feb 1; 40: 55-59.

IntroductionThis study seeks to determine the utility of D-dimer levels as a biomarker in determining disease severity and prognosis in COVID-19.MethodsClinical, imaging and laboratory data of 120 patients whose COVID-19 diagnosis based on RT-PCR were evaluated retrospectively. Clinically, the severity of COVID-19 was classified as noncomplicated or mild or severe pneumonia. Radiologically, the area of affected lungs compatible with viral pneumonia in each patient's computed tomography was classified as either 0-30% or ≥ 31% of the total lung area. The D-dimer values and laboratory data of patients with COVID-19 were compared with inpatient status, duration of hospitalization, and lung involvement during treatment and follow-up. To assess the predictive value of D-dimer, receiver operating characteristic (ROC) analysis was conducted.ResultsD-dimer elevation (> 243 ng/ml) was detected in 63.3% (76/120) of the patients. The mean D-dimer value was calculated as 3144.50 ± 1709.4 ng/ml (1643-8548) for inpatients with severe pneumonia in the intensive care unit. D-Dimer values showed positive correlations with age, duration of stay, lung involvement, fibrinogen, neutrophil count, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR). When the threshold D-dimer value was 370 ng/ml in the ROC analysis, this value was calculated to have 77% specificity and 74% sensitivity for lung involvement in patients with COVID-19.ConclusionD-Dimer levels in patients with COVID-19 correlate with outcome, but further studies are needed to see how useful they are in determining prognosis.Copyright © 2020 Elsevier Inc. All rights reserved.

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