D-dimer and Death in Critically Ill Patients With Coronavirus Disease 2019.

Objectives Hypercoagulability may be a key mechanism for acute organ injury and death in patients with severe coronavirus disease 2019, but the relationship between elevated plasma levels of D-dimer, a biomarker of coagulation activation, and mortality has not been rigorously studied. We examined the independent association between D-dimer and death in critically ill patients with coronavirus disease 2019. Design Multicenter cohort study. Setting ICUs at 68 hospitals across the United States. Patients Critically ill adults with coronavirus disease 2019 admitted to ICUs between March 4, 2020, and May 25, 2020, with a measured D-dimer concentration on ICU day 1 or 2. Interventions None. Measurements and main results The primary exposure was the highest normalized D-dimer level (assessed in four categories: Conclusions In a large multicenter cohort study of critically ill patients with coronavirus disease 2019, higher D-dimer levels were independently associated with a greater risk of death.