Zhang (2020)
D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19
Laboratory Findings
D-dimer (Abnormal at admission vs. Normal)
COVID-19 (death)
Hazard ratio: 22.400 (2.860-175.700) Adjusted model


Retrospective observational study

Medical records


Patients with laboratory confirmed Covid-19 were retrospective enrolled in Wuhan Asia General Hospital from January 12, 2020, to March 15, 2020.

Of 343 eligible patients, the median age was 62 years (IQR, 48?69), ranging from 18 years to 92 years. A total of 37.6% (129/343) patients were older than 65 years and 50.3% (174/343) patients were female. According to the optimum cutoff value, 276 patients’ D-dimer levels on admission were less than 2.0 µg/mL, and 67 patients had D-dimer levels over 2.0 µg/mL. Compared with those patients with D-dimer levels below 2.0 µg/mL, patients with D-dimer levels >=2.0 µg/mL had a higher incidence of underlying disease, such as diabetes (P = .007), hypertension (P < .001), coronary heart disease (P = .02), and stroke history (P < .001). Additionally, lower level of lymphocyte (P < .001), hemoglobin (P = .003), platelet count (P = .009), and higher level of neutrophil (P < .001), C-reactive protein (P < .001), and prothrombin time (P < .001) were also observed in those with D-dimer levels >=2.0 µg/mL.


64 Day

COVID-19 (death)


A total of 13 death events occurred during hospitalization, 12 of which were observed among patients with D-dimer levels >=2.0 µg/mL on admission as compared with only one such event in those with negative D-dimer levels (<2.0 µg/mL) on admission (12/67 vs 1/276).

Laboratory Findings


Abnormal: D-dimer level >=2.0µg/mL


Abnormal at admission

Hazard ratio

22.400 (2.860-175.700)




gender, age, with or without underlying disease

D-dimer = 2.0 ug/ml (fourfold increase) on admission might be the optimum cutoff to predict in-hospital mortality for Covid-19. The optimal D-dimer cutoff point and C-statistic of routine tests were evaluated by receiver operator characteristic (ROC) curve.