VPB0132 - The Impact of Sex on D-Dimer Levels and Disease Outcomes in Hospitalized COVID-19 Patients

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Olivia Saville

BScH
Queen's University
Belleville , Ontario, Canada

Co-Author(s)

Yousra Tera, MD PhD

Post-Doctoral Fellow
Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada
Kingston, Ontario, Canada
YD

Yan Deng

Research Assistant
Queen’s University
Kingston, Ontario, Canada
ME

Malak Elbatarny

MD, Resident R3 Cardiac Surgery, Toronto General Hospital
University of Toronto
Toronto, Ontario, Canada
Maha Othman, MD PhD

Professor
Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada,
Kingston, Ontario, Canada

Background: Males and females are similarly susceptible to COVID-19 infection. Multiple studies report male mortality rate to be nearly double that of females. Hypercoagulability is common in severe COVID-19 patients. D-dimer was reported as a significant marker for disease severity and mortality risk. It is unclear whether D-dimer levels differ between males and females. The effect of D-dimers on disease outcomes remains under investigation.

Aims: To evaluate the sex difference of D-dimer level in hospitalized COVID-19 patients and to determine the effect of sex on disease outcomes.

Methods: We searched EMBASE for articles published prior to October 1, 2021, evaluating D-dimer in adult males and females, hospitalized for COVID-19 and reporting on mortality, ICU admission, hospital stay and thrombotic complications. 3225 articles were retrieved. Comparative, observational prospective or retrospective, or case control studies were included. Studies including pregnancy, children, or a secondary disease focus were excluded. We meta-analysed data from 10 included studies using Cochrane RevMan 5 software.

Results: Of 11827 hospitalized COVID-19+ adults, 6519 (55%) were male and 5308 (45%) were female. Critical illness was experienced by 1681 (26%) males and 1228 (23%) females. Mortality occurred in 877 (13%) males and 548 (10%) females. In unadjusted analysis males had higher odds of experiencing critical illness and mortality. The Odds Ratios were 1.53 [95% CI: 1.36-1.72, I2 =77%, P= < 0.00001] and 1.40 [95% CI: 1.24-1.57, I2=0%, P= < 0.00001], respectively. The mean difference between male and female D-dimer level was 0.18 [95% CI: 0.13-0.23, I2=83%, P= < 0.00001]. The reporting of D-dimer assay calibration was inconsistent and D-dimer unit magnitude varied greatly between studies.

Conclusion(s): Males have higher mean D-dimer levels and are at higher risk of experiencing poor COVID-19 outcomes than females. The diversity in D-dimer reporting among different studies can impact data interpretation.