scholarly journals Reporting of D-dimer data in COVID-19: some confusion and potential for misinformation

2020 ◽  
Vol 58 (8) ◽  
pp. 1191-1199 ◽  
Emmanuel J. Favaloro ◽  
Jecko Thachil

AbstractCoronavirus disease 2019 (COVID-19) represents a new pandemic caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2). A previous pooled analysis clearly identified elevated D-dimer levels as being associated with severity of COVID-19. Since then, several other studies have provided clearer support for this initial evidence. However, potentially under-recognized by those reporting on D-dimer is the considerable variation in reporting units for D-dimer, and thus also the potential for misreporting of D-dimer data based on poor or incomplete reporting. A PubMed search was used to identify recent papers reporting on D-dimers in COVID-19-based studies. We report that: (1) most publications did not identify either the manufacturer or D-dimer product used; (2) most did not identify whether D-dimer values were reported as D-dimer units (DDU) or fibrinogen equivalent units (FEU) (~2 ×  differences); (3) nearly half did not identify normal cut-off values; (4) some did not report numerical findings or units for D-dimer; (5) where reported, most identified units as either mg/L or μg/mL; (6) we identified at least four errors in reporting from 21 papers. It may not be possible to truly standardize D-dimer assays, but it should be feasible to harmonize D-dimer assays to a single unit of measurement.

hautnah ◽  
2021 ◽  
Stanislava Tzaneva

ZusammenfassungDie Prävalenz der venösen thromboembolischen (VTE) Ereignisse ist bei Coronavirus diesease 2019 (COVID-19) -Patienten hoch, insbesondere bei schwer Erkrankten. Patienten mit schwerer COVID-19 und VTE haben eine signifikant höhere Mortalität im Vergleich zu Patienten ohne VTE. Die Manifestation einer schweren Infektion mit Severe acute respiratory syndrome coronavirus-2 (SARS-CoV‑2) entspricht einem systemischen proinflammatorischen und prokoagulatorischen Phänotyp, der mit vaskulären Thrombosen nicht nur in den Venen, sondern auch in den Arterien, Kapillaren sowie mit einer Inflammation der Gefäße assoziiert ist. Ein erhöhter D‑Dimer-Spiegel kann als Indikator für VTE bei Patienten mit COVID-19 verwendet werden. Die meisten medizinischen Gesellschaften empfehlen eine VTE-Prophylaxe vorzugsweise mit niedermolekularen Heparinen (LMWH) bei allen stationären Patienten. Weitere Daten von randomisierten kontrollierten Studien (RCTs) über die optimale Antikoagulation und antithrombotische Therapie werden in der nahen Zukunft erwartet.

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Giuseppe Lippi ◽  
Camilla Mattiuzzi ◽  
Brandon M. Henry

Abstract Objectives Despite inter-individual variations in their diagnostic efficiency, dogs have been trained to investigate many human pathologies, especially cancer, diabetes, migraine, seizures and even infectious diseases. To this end, we performed a critical review and pooled analysis of current scientific literature on the performance of dogs trained for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive human specimens. Methods We carried out an electronic search in PubMed, Scopus and Web of Science with the keywords “dog(s)” AND “sniffer” OR “scent” OR “smell” AND “SARS-CoV-2” OR “severe acute respiratory syndrome coronavirus 2” OR “coronavirus disease 2019” OR “COVID-19” within all fields, without date or language restrictions, to identify studies describing dogs’ performance for identifying SARS-CoV-2 infected material. Results Three studies could be finally included in pooled analysis, totaling 17 dogs (47% females), aged between 0.5 and 12 years. The pooled diagnostic sensitivity was 0.88 (95% CI, 0.84–0.91; I 2, 85.3%), the diagnostic specificity 0.99 (95% CI, 0.99–0.99; I 2, 97.4%), whilst the area under the summary receiver operating characteristic curve (SROC) was 0.979 (standard error, 0.003). Conclusions The notable performance observed in this pooled analysis would persuade us to suggest that adequately trained dogs could represent an intriguing and sustainable resource for purposes of rapid SARS-CoV-2 mass screening.

Clinton R Paden ◽  
Ying Tao ◽  
Krista Queen ◽  
Jing Zhang ◽  
Yan Li ◽  

AbstractSARS-CoV-2 recently emerged, resulting a global pandemic. Rapid genomic information is critical to understanding transmission and pathogenesis. Here, we describe validated protocols for generating high-quality full-length genomes from primary samples. The first employs multiplex RT-PCR followed by MinION or MiSeq sequencing. The second uses singleplex, nested RT-PCR and Sanger sequencing.

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Vikramaditya Reddy Samala Venkata ◽  
Rahul Gupta ◽  
Surya Kiran Aedma

Introduction: The pandemic of COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 infection. Although clinical data is limited, studies published so far raise concerns about an association between hypertension and worse clinical outcomes in COVID-19. Our aim was to assess the association between hypertension and mortality in COVID-19 patients. Methods: A systematic electronic search was performed in PubMed, Embase, and Google Scholar. Retrospective studies with original COVID-19 hospitalized patient data and reporting prevalence of hypertension was included in our study. Pooled analysis using a random-effects model was performed to look at the association between hypertension and mortality. Results: 22 studies from 8 countries with over 11,000 patients were included in our analysis. Hypertension was the most prevalent comorbidity in hospitalized COVID-19 patients (42%), followed by diabetes mellitus (23%)(Figure 1). Hypertension by itself was associated with higher rates of mortality (Figure 2). Other less prevalent comorbidities include non-hypertensive cardiovascular disease (11%), CKD (6%), CVA (5%), COPD (4.3%). Conclusion: Hypertension is the most prevalent comorbidity in hospitalized COVID-19 patients, followed by diabetes mellitus and was found to be significantly associated with higher rates of mortality. Surprisingly, hypertension is significantly more common than COPD in this population. The reason for this is unclear, there is no evidence currently that hypertension is directly related to mortality in this population. More randomized studies are needed to assess the effect of hypertension on mortality in COVID-19 patients.

Nidoviruses ◽  
2014 ◽  
pp. 379-407 ◽  
Luis Enjuanes ◽  
Marta L. DeDiego ◽  
Enrique Alvarez ◽  
Carmen Capiscol ◽  
Ralph Baric

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2260-2260
Takeshi Fuji ◽  
Satoru Fujita ◽  
Shintaro Tachibana ◽  
Yohko Kawai

Abstract Abstract 2260 Introduction: Edoxaban is an oral, once-daily, direct factor Xa inhibitor in clinical development for the prevention and treatment of thromboembolic events. Two randomized, double-blind, double-dummy, phase III studies (STARS E-3 and STARS J-V) have been conducted to evaluate the efficacy and safety of edoxaban compared to enoxaparin for the prevention of venous thromboembolism (VTE) after total knee arthroplasty (TKA) or total hip arthroplasty (THA). The objective of this pooled analysis was to investigate the effects of edoxaban on key coagulation biomarkers. Methods: Patients (N=1,326) undergoing TKA or THA in Japan and Taiwan were randomized to receive oral edoxaban 30 mg once daily (qd) or subcutaneous enoxaparin 2,000 IU twice daily (bid; equivalent to 20 mg bid) for 11–14 days. Edoxaban was initiated 6–24 hours after surgery and enoxaparin was initiated 24–36 hours after surgery, which is the standard of care in Japan. Blood samples were collected for coagulation biomarker measurements pre-operation, post-operation (pre-treatment, Day 0), Day 7 (prior to administration of the next dose) and completion day (Day 11–14). The primary efficacy outcome was the composite of symptomatic and asymptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE). The principal safety outcome was the incidence of major and clinically relevant non-major (CRNM) bleeding. Pharmacodynamic endpoints included key coagulation biomarkers such as D-dimer, prothrombin fragment F1+2 (F1+2) and soluble fibrin monomer complex (SFMC). Results: A total of 1,307 patients received at least 1 dose of edoxaban or enoxaparin. There were no clinically relevant differences in baseline characteristics between the treatment groups. The mean age was 68 years, mean body weight was 58.8 kg and 83% of patients were female. Overall, edoxaban significantly reduced the incidence of the composite of symptomatic and asymptomatic DVT and PE compared with enoxaparin (5.1% vs 10.7%, P<0.001). The incidence of major and CRNM bleeding events was 4.6% vs 3.7% in the edoxaban and enoxaparin groups, respectively (P=0.427). For both treatment groups, D-dimer and SFMC levels were reduced at Day 7 compared to post-operation/pretreatment levels, then increased slightly by Day 11–14. Levels of F1+2 also decreased by Day 7 in both treatment groups and further decreased by Day 11–14. However, for each coagulation biomarker, levels were significantly lower in the edoxaban group compared to the enoxaparin group at both Day 7 and Day 11–14. (Table, P<0.001). Conclusion: Edoxaban 30 mg qd is superior to enoxaparin 20 mg bid in the prevention of VTE events with significant reduction of D-dimer, F1+2 and SFMC following TKA and THA. Disclosures: Fuji: Daiichi Sankyo: Consultancy; Bayer: Consultancy; Century Medical: Consultancy; Showa Ikakogyo: Consultancy. Fujita:Daiichi Sankyo: Consultancy; Bayer: Consultancy. Tachibana:Daiichi Sankyo: Consultancy. Kawai:Daiichi Sankyo: Consultancy; Bayer: Consultancy; Toyama Chemical: Consultancy.

2021 ◽  
Tina J Dafoe ◽  
Theodore dos Santos ◽  
Aliya F Spigelman ◽  
James Lyon ◽  
Nancy Smith ◽  

Designated a pandemic in March 2020, the spread of severe acute respiratory syndrome virus 2 (SARS-CoV2), the virus responsible for coronavirus disease 2019 (COVID-19), led to new guidelines and restrictions being implemented for individuals, businesses, and societies in efforts to limit the impacts of COVID-19 on personal health and healthcare systems. Here we report the impacts of the COVID-19 pandemic on pancreas processing and islet isolation/distribution outcomes at the Alberta Diabetes Institute IsletCore, a facility specialising in the processing and distribution of human pancreatic islets for research. While the number of organs processed was significantly reduced, organ quality and the function of cellular outputs were minimally impacted during the pandemic when compared to an equivalent period immediately prior. Despite the maintained quality of isolated islets, recipient groups reported poorer feedback regarding the samples. Our findings suggest this is likely due to disrupted distribution which led to increased transit times to recipient labs, particularly those overseas. Thus, to improve overall outcomes in a climate of limited research islet supply, prioritization of tissue recipients based on likely tissue transit times may be needed.

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