Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia
Haowei Li,1,* Shimin Chen,1,* Shengshu Wang,1 Shanshan Yang,2 Wenzhe Cao,1 Shaohua Liu,1 Yang Song,1 Xuehang Li,1 Zhiqiang Li,3 Rongrong Li,1 Xiong Liu,3 Changjun Wang,3 Yong Chen,3 Fei Xie,4 Yao He,1 Miao Liu5 1Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics,...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2022-07-01
|
| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/elevated-d-dimer-and-adverse-in-hospital-outcomes-in-covid-19-patients-peer-reviewed-fulltext-article-IDR |
| _version_ | 1811297037219528704 |
|---|---|
| author | Li H Chen S Wang S Yang S Cao W Liu S Song Y Li X Li Z Li R Liu X Wang C Chen Y Xie F He Y Liu M |
| author_facet | Li H Chen S Wang S Yang S Cao W Liu S Song Y Li X Li Z Li R Liu X Wang C Chen Y Xie F He Y Liu M |
| author_sort | Li H |
| collection | DOAJ |
| description | Haowei Li,1,* Shimin Chen,1,* Shengshu Wang,1 Shanshan Yang,2 Wenzhe Cao,1 Shaohua Liu,1 Yang Song,1 Xuehang Li,1 Zhiqiang Li,3 Rongrong Li,1 Xiong Liu,3 Changjun Wang,3 Yong Chen,3 Fei Xie,4 Yao He,1 Miao Liu5 1Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China; 3Chinese PLA Center for Disease Control and Prevention, Beijing, People’s Republic of China; 4College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China; 5Graduate School of Chinese PLA General Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yao He, Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Diseases, Second Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People’s Republic of China, Tel +86-10-66876411, Email yhe301@sina.com Yong Chen, Chinese PLA Center for Disease Control and Prevention, 20 Dongdajie Road, Fengtai, Beijing, 100071, People’s Republic of China, Tel +86-10-66948344, Email chenyonger@126.comAim: One of the most common laboratory findings in COVID-19 patients has been observed to be hypercoagulability with elevated D-dimer levels. An activation of thrombosis may be generated by hyperglycemia. We aimed to explore the association between D-dimer and in-hospital outcomes, and evaluate the synergistic effect between elevated D-dimer and hyperglycemia on COVID-19 prognosis.Methods: A retrospective cohort study was undertaken with 2467 COVID-19 inpatients. D-dimer and fasting blood glucose (FBG) on admission and adverse in-hospital outcomes (events of death and aggravated severity) were collected. Cox proportional risk model was performed to assess the association of D-dimer and adverse in-hospital outcomes, and the combined effects of D-dimer and FBG.Results: Among these COVID-19 patients, 1100 (44.6%) patients had high D-dimer (≥ 0.50 mg/L). Patients with high D-dimer were older, with higher FBG (≥ 7.00 mmol/L), and had significantly higher adjusted risk of adverse in-hospital outcomes when comparing with those who with D-dimer< 0.50 mg/L (hazard ratio, 2.73; 95% confidence interval, 1.46– 5.11). Moreover, patients with high FBG and D-dimer levels had an increasing risk (hazard ratio, 5.72; 95% confidence interval: 2.65– 12.34) than those with normal FBG and D-dimer.Conclusion: Risk of adverse in-hospital outcomes is higher among patients with high D-dimer levels. Additionally, this study found for the first time that elevated D-dimer and hyperglycemia had a synergistic effect on COVID-19 prognosis, and this risk was independent of diabetes history.Keywords: D-dimer, hyperglycemia, in-hospital outcomes, COVID-19, cohort study |
| first_indexed | 2024-04-13T05:58:08Z |
| format | Article |
| id | doaj.art-d48ac0b488d846c6a01ec731e6550a2e |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-13T05:58:08Z |
| publishDate | 2022-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-d48ac0b488d846c6a01ec731e6550a2e2022-12-22T02:59:33ZengDove Medical PressInfection and Drug Resistance1178-69732022-07-01Volume 153683369176507Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with HyperglycemiaLi HChen SWang SYang SCao WLiu SSong YLi XLi ZLi RLiu XWang CChen YXie FHe YLiu MHaowei Li,1,* Shimin Chen,1,* Shengshu Wang,1 Shanshan Yang,2 Wenzhe Cao,1 Shaohua Liu,1 Yang Song,1 Xuehang Li,1 Zhiqiang Li,3 Rongrong Li,1 Xiong Liu,3 Changjun Wang,3 Yong Chen,3 Fei Xie,4 Yao He,1 Miao Liu5 1Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China; 3Chinese PLA Center for Disease Control and Prevention, Beijing, People’s Republic of China; 4College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China; 5Graduate School of Chinese PLA General Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yao He, Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Diseases, Second Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People’s Republic of China, Tel +86-10-66876411, Email yhe301@sina.com Yong Chen, Chinese PLA Center for Disease Control and Prevention, 20 Dongdajie Road, Fengtai, Beijing, 100071, People’s Republic of China, Tel +86-10-66948344, Email chenyonger@126.comAim: One of the most common laboratory findings in COVID-19 patients has been observed to be hypercoagulability with elevated D-dimer levels. An activation of thrombosis may be generated by hyperglycemia. We aimed to explore the association between D-dimer and in-hospital outcomes, and evaluate the synergistic effect between elevated D-dimer and hyperglycemia on COVID-19 prognosis.Methods: A retrospective cohort study was undertaken with 2467 COVID-19 inpatients. D-dimer and fasting blood glucose (FBG) on admission and adverse in-hospital outcomes (events of death and aggravated severity) were collected. Cox proportional risk model was performed to assess the association of D-dimer and adverse in-hospital outcomes, and the combined effects of D-dimer and FBG.Results: Among these COVID-19 patients, 1100 (44.6%) patients had high D-dimer (≥ 0.50 mg/L). Patients with high D-dimer were older, with higher FBG (≥ 7.00 mmol/L), and had significantly higher adjusted risk of adverse in-hospital outcomes when comparing with those who with D-dimer< 0.50 mg/L (hazard ratio, 2.73; 95% confidence interval, 1.46– 5.11). Moreover, patients with high FBG and D-dimer levels had an increasing risk (hazard ratio, 5.72; 95% confidence interval: 2.65– 12.34) than those with normal FBG and D-dimer.Conclusion: Risk of adverse in-hospital outcomes is higher among patients with high D-dimer levels. Additionally, this study found for the first time that elevated D-dimer and hyperglycemia had a synergistic effect on COVID-19 prognosis, and this risk was independent of diabetes history.Keywords: D-dimer, hyperglycemia, in-hospital outcomes, COVID-19, cohort studyhttps://www.dovepress.com/elevated-d-dimer-and-adverse-in-hospital-outcomes-in-covid-19-patients-peer-reviewed-fulltext-article-IDRd-dimerhyperglycemiain-hospital outcomescovid-19cohort study |
| spellingShingle | Li H Chen S Wang S Yang S Cao W Liu S Song Y Li X Li Z Li R Liu X Wang C Chen Y Xie F He Y Liu M Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia Infection and Drug Resistance d-dimer hyperglycemia in-hospital outcomes covid-19 cohort study |
| title | Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia |
| title_full | Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia |
| title_fullStr | Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia |
| title_full_unstemmed | Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia |
| title_short | Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia |
| title_sort | elevated d dimer and adverse in hospital outcomes in covid 19 patients and synergism with hyperglycemia |
| topic | d-dimer hyperglycemia in-hospital outcomes covid-19 cohort study |
| url | https://www.dovepress.com/elevated-d-dimer-and-adverse-in-hospital-outcomes-in-covid-19-patients-peer-reviewed-fulltext-article-IDR |
| work_keys_str_mv | AT lih elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT chens elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT wangs elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT yangs elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT caow elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT lius elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT songy elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT lix elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT liz elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT lir elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT liux elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT wangc elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT cheny elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT xief elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT hey elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia AT lium elevatedddimerandadverseinhospitaloutcomesincovid19patientsandsynergismwithhyperglycemia |