{"doi":"10.1161/atvbaha.120.314872","title":"Prevalence and Outcomes of D-Dimer Elevation in Hospitalized Patients With COVID-19","abstract":"Objective: To determine the prevalence of D-dimer elevation in coronavirus disease 2019 (COVID-19) hospitalization, trajectory of D-dimer levels during hospitalization, and its association with clinical outcomes. Approach and Results: Consecutive adults admitted to a large New York City hospital system with a positive polymerase chain reaction test for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) between March 1, 2020 and April 8, 2020 were identified. Elevated D-dimer was defined by the laboratory-specific upper limit of normal (>230 ng/mL). Outcomes included critical illness (intensive care, mechanical ventilation, discharge to hospice, or death), thrombotic events, acute kidney injury, and death during admission. Among 2377 adults hospitalized with COVID-19 and ≥1 D-dimer measurement, 1823 (76%) had elevated D-dimer at presentation. Patients with elevated presenting baseline D-dimer were more likely than those with normal D-dimer to have critical illness (43.9% versus 18.5%; adjusted odds ratio, 2.4 [95% CI, 1.9–3.1]; P <0.001), any thrombotic event (19.4% versus 10.2%; adjusted odds ratio, 1.9 [95% CI, 1.4–2.6]; P <0.001), acute kidney injury (42.4% versus 19.0%; adjusted odds ratio, 2.4 [95% CI, 1.9–3.1]; P <0.001), and death (29.9% versus 10.8%; adjusted odds ratio, 2.1 [95% CI, 1.6–2.9]; P <0.001). Rates of adverse events increased with the magnitude of D-dimer elevation; individuals with presenting D-dimer >2000 ng/mL had the highest risk of critical illness (66%), thrombotic event (37.8%), acute kidney injury (58.3%), and death (47%). Conclusions: Abnormal D-dimer was frequently observed at admission with COVID-19 and was associated with higher incidence of critical illness, thrombotic events, acute kidney injury, and death. The optimal management of patients with elevated D-dimer in COVID-19 requires further study.","journal":"Arteriosclerosis Thrombosis and Vascular Biology","year":2020,"id":50450,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":193,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6491,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":229765,"name":"Dennis Kunichoff","orcid":null,"position":1,"is_corresponding":false},{"id":247795,"name":"Samrachana Adhikari","orcid":"0000-0001-9954-5999","position":2,"is_corresponding":false},{"id":247796,"name":"Tania Ahuja","orcid":"0000-0003-1833-4124","position":3,"is_corresponding":false},{"id":247797,"name":"Nancy Amoroso","orcid":"0009-0005-3932-5018","position":4,"is_corresponding":false},{"id":52496,"name":"Yindalon Aphinyanaphongs","orcid":"0000-0001-8605-5392","position":5,"is_corresponding":false},{"id":247798,"name":"Meng Cao","orcid":"0000-0002-4716-215X","position":6,"is_corresponding":false},{"id":247799,"name":"Ronald Goldenberg","orcid":"0000-0002-0717-7250","position":7,"is_corresponding":false},{"id":247800,"name":"Alexander Hindenburg","orcid":"0000-0002-1232-2168","position":8,"is_corresponding":false},{"id":247801,"name":"James M. Horowitz","orcid":"0000-0002-8220-5434","position":9,"is_corresponding":false},{"id":247802,"name":"Sam Parnia","orcid":"0000-0002-6158-4404","position":10,"is_corresponding":false},{"id":247803,"name":"Christopher M. Petrilli","orcid":"0000-0002-1424-401X","position":11,"is_corresponding":false},{"id":225668,"name":"Harmony R. Reynolds","orcid":"0000-0003-0284-0655","position":12,"is_corresponding":false},{"id":247804,"name":"Emma Simon","orcid":"0000-0001-5831-0616","position":13,"is_corresponding":false},{"id":247805,"name":"James Slater","orcid":"0000-0003-3888-0317","position":14,"is_corresponding":false},{"id":108616,"name":"Shadi Yaghi","orcid":"0000-0003-0031-1004","position":15,"is_corresponding":false},{"id":247806,"name":"Eugene Yuriditsky","orcid":"0000-0003-2263-9297","position":16,"is_corresponding":false},{"id":225667,"name":"Judith S. Hochman","orcid":"0000-0002-5889-5981","position":17,"is_corresponding":false},{"id":247807,"name":"Leora I. Horwitz","orcid":"0000-0003-1800-6040","position":18,"is_corresponding":false},{"id":225663,"name":"Jeffrey S. Berger","orcid":"0000-0001-8216-4647","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T20:38:25.860949Z","pmid":"32840379","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}