OR51. Prognostic Value and Influencing Factors of High D-dimer Levels for Critical Care Needs in Coronavirus Disease 2019 (COVID-19) Patients

Coronavirus disease 2019 (COVID-19) stimulates pro-thrombotic changes that lead to poor prognosis-associated conditions. Early and effective predictors of clinical outcomes are urgently needed to improve management. This study aims to explore the value and influencing factors of high D-dimer levels on the prognosis of critical care needs in COVID-19 patients.

Patients admitted with confirmed COVID-19 in Dr. Iskak General Hospital from June to December 2020 were retrospectively enrolled. We examined the relationship between peripheral blood levels of D-dimer on admission, clinical characteristic, prognosis, and its related influencing factors. One hundred forty-eight patients were included in analysis. D-dimer levels of patients who need critical care needs were significantly higher (p < 0.001). The Receiver Operating Characteristic (ROC) curve was used to evaluate the sensitivity and specificity of D-dimer in predicting critical care needs. The optimal cut-off value of D-dimer to predict critical care needs was 1,707 ng/ml with a sensitivity of 84.6% and specificity of 84.4% (AUC=92.6%; 95% CI = 0.87-0.98). In addition, we found that patients with advanced age (OR 10.5, 95% CI 1.94-57.35, p = 0.005), history of stroke (OR 4.1, 95% CI 1.11-15.22, p = 0.039) and renal failure (OR 8.1, 95% CI 1.41-46.71, p = 0.020) had higher D-dimer levels.

D-dimer can be used to evaluate the prognosis of critical care needs of COVID-19 patients. The D-dimer value of 1,707 ng/ml was the optimal probability cut-off for judging critical care needs. Advanced age, history of stroke and renal failure are influencing factors for D-dimer levels, which impact the prognosis of patients.