Takeaway
- D-dimer and lactate dehydrogenase (LDH) are among 5 biomarkers that may independently predict clinical deterioration and death in hospitalized patients with COVID-19.
Why this matters
- Elevated biomarkers of inflammation and coagulopathy identify high-risk patients who may need more aggressive early treatment.
Study design
- Retrospective cohort of 299 US patients with laboratory-confirmed COVID-19 admitted to George Washington University Hospital in the District of Columbia (March 12-May 9, 2020).
- 5 blood-based biomarkers were assayed on hospital admission: D-dimer, LDH, C-reactive protein (CRP), IL-6, and ferritin.
- Funding: None disclosed.
Key results
- 23% of patients were transferred to the ICU, 13% required intubation, and 23.7% died.
- Elevations of D-dimer (≥3 μg/mL), LDH (≥1200 units/L), CRP (≥100 mg/L), IL-6 (≥50 pg/mL), and ferritin (≥450 ng/mL) were each independently associated with elevated odds of these 3 clinical outcomes:
- aORs ranged from 4.5 (95% CI, 2.5-8.1) to 8.6 (95% CI, 4.1-18.1).
- All P<.05.>
- Highest mortality odds (aORs; 95% CIs) with:
- Elevated LDH: 8.0 (4.1-15.3).
- D-dimer: 7.5 (3.8-14.6).
Limitations
- Single-center study.
- Retrospective, observational design.
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