Simone Magalhães Diniz, Vitor Augusto Queiroz Mauad, Caio Cesar Ferreira Fernandes, Marcelo Rodrigues Bacci
{"title":"评估作为 COVID-19 急性呼吸窘迫患者预后生物标志物的 d-二聚体。","authors":"Simone Magalhães Diniz, Vitor Augusto Queiroz Mauad, Caio Cesar Ferreira Fernandes, Marcelo Rodrigues Bacci","doi":"10.1590/S1678-9946202466057","DOIUrl":null,"url":null,"abstract":"<p><p>Acute respiratory distress syndrome is a significant complication in critical care patients. COVID-19 (C19)-associated severe respiratory failure is related to it, and d-dimer rise predicts a worse outcome. To investigate the association between d-dimer and the severity of this respiratory syndrome, we conducted a study in C19 intubated patients. A retrospective, single-center observational study was conducted with 64 C19 adult intubated patients. Strata of d-dimer results between patients was evaluated using survival analysis. Survival was higher in mild respiratory distress patients. D-dimer showed poor sensitivity and specificity in predicting respiratory failure severity. Risk assessment for death showed a higher prevalence of admission d-dimer results (HR 1.335; 95% CI 0.695-2.564). Our sample confidently represented the medical profile of C19 severe patients. Sepsis development in C19 is associated with the inflammatory storm in respiratory distress syndrome. As the receiver operating curves show, the increase in d-dimer results is consistent with inflammation rather than a prognostic biomarker. As expected, severe respiratory distress patients presented higher mortality. In summary, d-dimer results are not associated with the prognosis of C19 respiratory distress syndrome patients.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"66 ","pages":"e57"},"PeriodicalIF":1.5000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421419/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of d-dimer as outcome biomarker in COVID-19 acute respiratory distress patients.\",\"authors\":\"Simone Magalhães Diniz, Vitor Augusto Queiroz Mauad, Caio Cesar Ferreira Fernandes, Marcelo Rodrigues Bacci\",\"doi\":\"10.1590/S1678-9946202466057\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Acute respiratory distress syndrome is a significant complication in critical care patients. COVID-19 (C19)-associated severe respiratory failure is related to it, and d-dimer rise predicts a worse outcome. To investigate the association between d-dimer and the severity of this respiratory syndrome, we conducted a study in C19 intubated patients. A retrospective, single-center observational study was conducted with 64 C19 adult intubated patients. Strata of d-dimer results between patients was evaluated using survival analysis. Survival was higher in mild respiratory distress patients. D-dimer showed poor sensitivity and specificity in predicting respiratory failure severity. Risk assessment for death showed a higher prevalence of admission d-dimer results (HR 1.335; 95% CI 0.695-2.564). Our sample confidently represented the medical profile of C19 severe patients. Sepsis development in C19 is associated with the inflammatory storm in respiratory distress syndrome. As the receiver operating curves show, the increase in d-dimer results is consistent with inflammation rather than a prognostic biomarker. As expected, severe respiratory distress patients presented higher mortality. In summary, d-dimer results are not associated with the prognosis of C19 respiratory distress syndrome patients.</p>\",\"PeriodicalId\":54466,\"journal\":{\"name\":\"Revista Do Instituto De Medicina Tropical De Sao Paulo\",\"volume\":\"66 \",\"pages\":\"e57\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421419/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Do Instituto De Medicina Tropical De Sao Paulo\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/S1678-9946202466057\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Do Instituto De Medicina Tropical De Sao Paulo","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/S1678-9946202466057","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Evaluation of d-dimer as outcome biomarker in COVID-19 acute respiratory distress patients.
Acute respiratory distress syndrome is a significant complication in critical care patients. COVID-19 (C19)-associated severe respiratory failure is related to it, and d-dimer rise predicts a worse outcome. To investigate the association between d-dimer and the severity of this respiratory syndrome, we conducted a study in C19 intubated patients. A retrospective, single-center observational study was conducted with 64 C19 adult intubated patients. Strata of d-dimer results between patients was evaluated using survival analysis. Survival was higher in mild respiratory distress patients. D-dimer showed poor sensitivity and specificity in predicting respiratory failure severity. Risk assessment for death showed a higher prevalence of admission d-dimer results (HR 1.335; 95% CI 0.695-2.564). Our sample confidently represented the medical profile of C19 severe patients. Sepsis development in C19 is associated with the inflammatory storm in respiratory distress syndrome. As the receiver operating curves show, the increase in d-dimer results is consistent with inflammation rather than a prognostic biomarker. As expected, severe respiratory distress patients presented higher mortality. In summary, d-dimer results are not associated with the prognosis of C19 respiratory distress syndrome patients.
期刊介绍:
The Revista do Instituto de Medicina Tropical de São Paulo (Journal of the São Paulo Institute of Tropical Medicine) is a journal devoted to research on different aspects of tropical infectious diseases. The journal welcomes original work on all infectious diseases, provided that data and results are directly linked to human health.
The journal publishes, besides original articles, review articles, case reports, brief communications, and letters to the editor. The journal publishes manuscripts only in English.
From 2016 on, the Revista do Instituto de Medicina Tropical de São Paulo (Journal of the São Paulo Institute of Tropical Medicine) is published online only, maintaining the free access.
For more information visit:
- http://www.scielo.br/rimtsp
- http://www.imt.usp.br/revista-imt/