Predicting pulmonary embolism in patients infected with COVID-19 based on D-dimer levels and days between diagnosis of the infection and D-dimer determination

Submitted: September 24, 2020
Accepted: January 21, 2021
Published: March 11, 2021
Abstract Views: 1656
PDF: 902
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Ruling out pulmonary embolism (PE) can be challenging in a situation of elevated D-dimer values such as in a case of COVID-19 infection. Our objective was to evaluate the difference in D-dimer values of subjects infected with COVID-19 in those with PE and those without and to analyze the predictive value of D-dimer for PE in these subjects based on the day of D-dimer determination. This was an observational, retrospective study, conducted at a tertiary hospital. All subjects with PCR-confirmed COVID-19 infection requiring hospital admission at our institution between the months of March and April 2020 were included in the study. We compared D-dimer levels in subjects who went on to develop a PE and those who did not. We then created a model to predict the subsequent development of a PE with the current D-dimer levels of the subject. D-dimer levels changed over time from COVID-19 diagnosis, but were always higher in subjects who went on to develop a PE. Regarding the predictive model created, the area under the curve of the ROC analyses of the cross-validation predictions was 0.72. The risk of pulmonary embolism for the same D-dimer levels varied depending on the number of days elapsed since COVID-19 diagnosis and D-dimer determination. To conclude, D-dimer levels were elevated in subjects with a COVID-19 infection, especially in those with PE. D-dimer levels increased during the first 10 days after the diagnosis of the infection and can be used to predict the risk of PE in COVID-19 subjects.

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Ignasi Garcia-Olivé, Department of Respiratory Medicine

CibeRes, Ciber de Enfermedades Respiratorias, Spain;
Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain;
Departament de Medicina, Universitat Autònoma de Barcelona, Spain

Helena Sintes, Department of Respiratory Medicine

Departament de Medicina, Universitat Autònoma de Barcelona, Spain

Joaquim Radua, Imaging of Mood- and Anxiety-Related Disorders (IMARD) group

CIBERSAM, Madrid, Spain;
Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK;
Department of Clinical Neuroscience, Stockholm Health Care Services, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden

Jorge Abad Capa, Department of Respiratory Medicine

CibeRes, Ciber de Enfermedades Respiratorias, Spain;
Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain;
Departament de Medicina, Universitat Autònoma de Barcelona, Spain

Antoni Rosell, Department of Respiratory Medicine

CibeRes, Ciber de Enfermedades Respiratorias, Spain;
Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain;
Departament de Medicina, Universitat Autònoma de Barcelona, Spain

How to Cite

Garcia-Olivé, Ignasi, Helena Sintes, Joaquim Radua, Jordi Deportos, Isabel Nogueira, Cristian Morales-Indiano, Jorge Abad Capa, and Antoni Rosell. 2021. “Predicting Pulmonary Embolism in Patients Infected With COVID-19 Based on D-Dimer Levels and Days Between Diagnosis of the Infection and D-Dimer Determination”. Monaldi Archives for Chest Disease 91 (2). https://doi.org/10.4081/monaldi.2021.1622.

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