Ann Phlebology 2022; 20(1): 6-8
Published online June 30, 2022
https://doi.org/10.37923/phle.2022.20.1.6
© Annals of phlebology
Correspondence to : Chung Won Lee, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea, Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine
Tel: 02-51-240-7295, Fax: 02-51-243-9389
E-mail: vasculardoctorlee@gmail.com
COVID-19, a pandemic currently, is known to cause hypercoagulability, but may cause deep vein thrombosis (DVT). Generally, D-dimer is useful for diagnosing DVT, but in COVID-19 patients, there is a high possibility of false positives due to the accompanying infection. A literature review revealed that D-dimer levels are elevated in patients with COVID-19. Therefore, a new D-dimer cutoff value for DVT in COVID-19 is needed. Higher D-dimer levels in COVID-19 patients are significantly associated with disease progression.
Keywords Deep vein thrombosis, COVID-19, D-dimer, Thrombosis, Coronavirus
COVID-19 has been a pandemic since December 2019. According to a WHO report, in April 2022, more than 500 million people worldwide were confirmed to be COVID-19 positive, and more than 6 million deaths were reported. COVID-19 can cause hypercoagulation due to endothelial damage, which can lead to pulmonary embolism (PE) or deep vein thrombosis (DVT), resulting in a poor prognosis (
As degradation products of fibrin, D-dimers are typically used in the diagnosis of PE and DVT. However, diagnosing DVT with D-dimers is problematic as it shows false positives in cases of infection, pregnancy, malignancy, post surgery, renal disease, heart disease etc. (
There are many reports of DVT in patients with COVID-19 (
Recently, guidelines have recommended standard-dose anticoagulant prophylaxis for critically ill patients with COVID-19 (
Most patients with COVID-19 showed an increase in the D-dimer level regardless of DVT. According to Cho et al. (
According to Cui et al. (
It is less useful in COVID-19 patients to exclude DVT with a conventional cutoff value, warranting a new cutoff value. However, even after analyzing many studies, it is difficult to determine a usable cutoff value because the measurement time points of D-dimer levels are not constant, and the units of measurement are different (D-dimer unit or fibrinogen equivalent unit).
Several studies have reported that an increased D-dimer level is directly related to disease severity and progression and high mortality outcomes in COVID-19 (
In a meta-analysis conducted by Varikasuvu et al. (
Zhan et al. (
Since D-dimer levels are elevated in patients with COVID-19, it is difficult to screen for DVT by applying a traditional cutoff. Although D-dimer levels are limited in diagnosing DVT in patients with COVID-19, higher D-dimer levels in this patient group are significantly associated with disease progression. Further research is needed on the correlation between DVT and D-dimer levels in COVID-19 patients.
This paper was presented at the 42nd Conference of the Korean Society for Phlebology on April 17, 2022. This work was supported by clinical research grant from Pusan National University Hospital in 2022.
The author declares no potential conflict of interest.
Ann Phlebology 2022; 20(1): 6-8
Published online June 30, 2022 https://doi.org/10.37923/phle.2022.20.1.6
Copyright © Annals of phlebology.
Chung Won Lee, M.D., Ph.D.
Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
Correspondence to:Chung Won Lee, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea, Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine
Tel: 02-51-240-7295, Fax: 02-51-243-9389
E-mail: vasculardoctorlee@gmail.com
COVID-19, a pandemic currently, is known to cause hypercoagulability, but may cause deep vein thrombosis (DVT). Generally, D-dimer is useful for diagnosing DVT, but in COVID-19 patients, there is a high possibility of false positives due to the accompanying infection. A literature review revealed that D-dimer levels are elevated in patients with COVID-19. Therefore, a new D-dimer cutoff value for DVT in COVID-19 is needed. Higher D-dimer levels in COVID-19 patients are significantly associated with disease progression.
Keywords: Deep vein thrombosis, COVID-19, D-dimer, Thrombosis, Coronavirus
COVID-19 has been a pandemic since December 2019. According to a WHO report, in April 2022, more than 500 million people worldwide were confirmed to be COVID-19 positive, and more than 6 million deaths were reported. COVID-19 can cause hypercoagulation due to endothelial damage, which can lead to pulmonary embolism (PE) or deep vein thrombosis (DVT), resulting in a poor prognosis (
As degradation products of fibrin, D-dimers are typically used in the diagnosis of PE and DVT. However, diagnosing DVT with D-dimers is problematic as it shows false positives in cases of infection, pregnancy, malignancy, post surgery, renal disease, heart disease etc. (
There are many reports of DVT in patients with COVID-19 (
Recently, guidelines have recommended standard-dose anticoagulant prophylaxis for critically ill patients with COVID-19 (
Most patients with COVID-19 showed an increase in the D-dimer level regardless of DVT. According to Cho et al. (
According to Cui et al. (
It is less useful in COVID-19 patients to exclude DVT with a conventional cutoff value, warranting a new cutoff value. However, even after analyzing many studies, it is difficult to determine a usable cutoff value because the measurement time points of D-dimer levels are not constant, and the units of measurement are different (D-dimer unit or fibrinogen equivalent unit).
Several studies have reported that an increased D-dimer level is directly related to disease severity and progression and high mortality outcomes in COVID-19 (
In a meta-analysis conducted by Varikasuvu et al. (
Zhan et al. (
Since D-dimer levels are elevated in patients with COVID-19, it is difficult to screen for DVT by applying a traditional cutoff. Although D-dimer levels are limited in diagnosing DVT in patients with COVID-19, higher D-dimer levels in this patient group are significantly associated with disease progression. Further research is needed on the correlation between DVT and D-dimer levels in COVID-19 patients.
This paper was presented at the 42nd Conference of the Korean Society for Phlebology on April 17, 2022. This work was supported by clinical research grant from Pusan National University Hospital in 2022.
The author declares no potential conflict of interest.
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