Assessment of D-Dimer and Ferritin as Predictive Biomarkers for Thromboembolic Events in Hospitalized COVID-19 Patients at Modares Hospital: A Retrospective Study

Sasan  Tavana; Ali  Dabbagh; Fatemeh  Soltaninia

doi:10.18502/aacc.v11i5.19935

Sasan Tavana Department of Pulmonary Medicine, Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Dabbagh Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Fatemeh Soltaninia School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v11i5.19935

Keywords: COVID-19; Thromboembolism; Prognosis; D-dimer; Ferritin

Abstract

Background: The COVID-19 pandemic has been associated with a significant prevalence of thromboembolism. This study aimed to identify the predictive effect of D-dimer and ferritin on thromboembolism occurrences in hospitalized COVID-19 patients.

Methods: This retrospective study examined 304 patients with COVID-19, with a mean age of 62.33 ± 17 years, hospitalized at Modares Hospital from March 2020 to March 2021. The case group (PTE) comprised patients who experienced thrombosis complications during hospitalization (152 patients), while the control group (Non-PTE) consisted of patients who did not encounter thrombosis complications during their hospital stay (152 patients). Demographic data, clinical information, and laboratory findings were gathered and documented from patient records. The study examined the impact of D-dimer and ferritin as predictors of thromboembolism in patients.

Results: In this study, 100 patients died, with 75 (75%) of these fatalities occurring in the PTE group. The results indicated that PTE patients exhibited higher BMI (28.36 ± 1.87 vs. 27.76 ± 1.31 kg/cm², P<0.001), longer hospital stays (11.2 vs. 8.5 days, P=0.0009), increased ICU admissions (61.8 vs. 26.3%, P<0.001), higher smoking rates (21.9 vs. 4.8%, P<0.001), and greater prevalence of chronic lung disease (13.2 vs. 2.6%, P=0.001) compared to non-PTE patients. Analysis of the laboratory findings indicated a significant increase in lymphocyte count (P=0.034) and C-reactive protein (CRP) 3+ levels (P=0.04) in the PTE group compared to the non-PTE group. The D-dimer concentration in the PTE group was 4178.80 ± 1148.78 ng/ml, while in the non-PTE group it was 606.04 ± 656.86 ng/ml (1.03 OR, 95% CI=1.04-1.02, P<0.001). The ferritin level in the PTE group was recorded at 1639.33 ± 514.38, while in the Non-PTE group, a measurement of 420.48 ± 322.65 ng/ml was recorded (OR: 1.06, CI95%=1.07-1.04, P<0.001).

Conclusion: Elevated serum levels of ferritin and D-dimer in COVID-19 patients correlate with an increased risk of thromboembolism. Consequently, elevated concentrations of these parameters in hospitalized patients should serve as a warning to clinicians, necessitating careful attention and prompt treatment interventions.