Can D-dimer predict length of hospital stay in COVID-19 survivors? A crosssectional study

Abstract

Background: COVID-19 has been shown to increase the risk of thrombosis, where this mechanism occurs due to cell damage that triggers the release of various proinflammatory cytokines and chemokines, thereby activating the coagulation cascade. Thus, an increase D-dimer levels in COVID-19 patients occurs. Patients’ length of hospital stay (LOS) is pivotal in order to improve patient care, lower overall expenses, and distribute resources effectively. Purpose: This study aims to identify the association between D-dimer and other parameters as a predictor of LOS in COVID-19 survivors. Methods: This observational analytic study included COVID-19 patients who were admitted to Universitas Sebelas Maret Hospital in Sukoharjo, Indonesia, from November 2020 to January 2021. The data were taken from the medical records of patients diagnosed with COVID-19. Age, gender, comorbidities, admission oxygen saturation, D-dimer, neutrophil-lymphocyte ratio (NLR), haemoglobin, platelet count, white blood cells (WBC), estimated glomerular filtration rate (eGFR), and LOS were analysed in this study. Binary logistic regression was applied to determine the correlation between potential predictors on LOS. Results: A total 104 patients was included in the final analysis. The median LOS was 13 days (IQR 9-17 days). There was an increase of D-dimer in 79 patients with the median 759.39 ng/ml. Patients with prolonged LOS tend to have higher D-dimer levels (Median 924.95 vs 591.54 ng/ml, p = 0.018). However, D-dimer and other parameters were not associated with prolonged LOS in COVID-19 survivors (D-dimer p = 0.188; Age p = 0.138; Diabetes mellitus p = 0.172; NLR p = 0.859; Platelet count p = 0.097). Conclusion: D-dimer levels do not accurately predict prolonged LOS in COVID-19 survivors. Therefore, we suggest D-dimer solely should not be used as a tool to predict a patient’s LOS