Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19
Abstract Background Rapid progression of symptoms and development of Acute Respiratory Distress Syndrome (ARDS) frequently occurred during COVID-19 pandemic, while CT-Scan was useful to assess severity of lung damage, with classic patterns like early Ground Glass Opacity and/or late consolidation. L...
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BMC
2025-02-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-025-03531-1 |
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| author | Juan Antonio Suárez-Cuenca José Fernando Flores-Zaleta Leslie Andrea Corona-Rojas Pablo Guzmán-Rullán Luis Alfonso Camacho-Barajas Uzziel Aguilera-Ontiveros Alberto Melchor-López Alejandro González-Mora Perla Marlene Guzmán-Ramírez Janicia Rodríguez-Solis |
| author_facet | Juan Antonio Suárez-Cuenca José Fernando Flores-Zaleta Leslie Andrea Corona-Rojas Pablo Guzmán-Rullán Luis Alfonso Camacho-Barajas Uzziel Aguilera-Ontiveros Alberto Melchor-López Alejandro González-Mora Perla Marlene Guzmán-Ramírez Janicia Rodríguez-Solis |
| author_sort | Juan Antonio Suárez-Cuenca |
| collection | DOAJ |
| description | Abstract Background Rapid progression of symptoms and development of Acute Respiratory Distress Syndrome (ARDS) frequently occurred during COVID-19 pandemic, while CT-Scan was useful to assess severity of lung damage, with classic patterns like early Ground Glass Opacity and/or late consolidation. Likewise, lung injury has been related to activation of the coagulation-fibrinolysis systems and pro-inflammatory mediators; where D-Dimer acquires prognostic relevance. The present study aimed to evaluate whether the extent of lung involvement and pattern of lung injury, as determined by chest CT-scan, are related with D-Dimer; and further impact clinical prognosis in patients with ARDS due to COVID-19. Methods Longitudinal, prospective, observational, multi-center study. Patients diagnosed with ARDS due to COVID-19, without previous lung damage, clotting disorder and/or anticoagulants use, who were attended at the Intensive Care Unit and Internal Medicine Department from March to June 2020. Tomographic extent of lung involvement was analyzed by image software, as well as damage patterns, assessed by experienced radiologists. Endpoints included relation of lung injury with coagulopathy markers like D-Dimer, and prognostic outcome including mortality, mechanical ventilation and hospitalization time. Results One-hundred and four patients mean aged 55 years old, 66% males, main comorbidities obesity, hypertension and diabetes mellitus. Larger lung damage was associated with older age, male gender and higher pro-inflammatory mediators like leukocytes and ferritin; whilst consolidation pattern was related to higher Body Mass Index. Higher values of D-Dimer were related either to a larger extent of lung involvement or late consolidation pattern. In addition, the extent of lung involvement was related with longer hospital stay, higher requirement of mechanical ventilation (HR 0.12, p < 0.01) and mortality rate (HR 0.13, p < 0.01); whereas late consolidation was mainly associated with requirement of mechanical ventilation (HR 0.23, p < 0.01). Conclusion Tomographic extent of lung involvement and the pattern of lung injury are related with coagulopathy severity markers like D-Dimer, and own prognostic clinical ability in ARDS. |
| format | Article |
| id | doaj-art-772e23b9734842deb24cb4f992efbdb1 |
| institution | Kabale University |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Pulmonary Medicine |
| spelling | doaj-art-772e23b9734842deb24cb4f992efbdb12025-02-09T12:09:31ZengBMCBMC Pulmonary Medicine1471-24662025-02-012511810.1186/s12890-025-03531-1Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19Juan Antonio Suárez-Cuenca0José Fernando Flores-Zaleta1Leslie Andrea Corona-Rojas2Pablo Guzmán-Rullán3Luis Alfonso Camacho-Barajas4Uzziel Aguilera-Ontiveros5Alberto Melchor-López6Alejandro González-Mora7Perla Marlene Guzmán-Ramírez8Janicia Rodríguez-Solis9Unidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoUnidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoUnidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoUnidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoUnidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoInternal Medicine Department, Hospital General Xoco, SS CDMXInternal Medicine Department, Hospital General Xoco, SS CDMXUnidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoUnidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoUnidad de Cuidados Intensivos, Corporativo Hospital Satélite. City of State of MexicoAbstract Background Rapid progression of symptoms and development of Acute Respiratory Distress Syndrome (ARDS) frequently occurred during COVID-19 pandemic, while CT-Scan was useful to assess severity of lung damage, with classic patterns like early Ground Glass Opacity and/or late consolidation. Likewise, lung injury has been related to activation of the coagulation-fibrinolysis systems and pro-inflammatory mediators; where D-Dimer acquires prognostic relevance. The present study aimed to evaluate whether the extent of lung involvement and pattern of lung injury, as determined by chest CT-scan, are related with D-Dimer; and further impact clinical prognosis in patients with ARDS due to COVID-19. Methods Longitudinal, prospective, observational, multi-center study. Patients diagnosed with ARDS due to COVID-19, without previous lung damage, clotting disorder and/or anticoagulants use, who were attended at the Intensive Care Unit and Internal Medicine Department from March to June 2020. Tomographic extent of lung involvement was analyzed by image software, as well as damage patterns, assessed by experienced radiologists. Endpoints included relation of lung injury with coagulopathy markers like D-Dimer, and prognostic outcome including mortality, mechanical ventilation and hospitalization time. Results One-hundred and four patients mean aged 55 years old, 66% males, main comorbidities obesity, hypertension and diabetes mellitus. Larger lung damage was associated with older age, male gender and higher pro-inflammatory mediators like leukocytes and ferritin; whilst consolidation pattern was related to higher Body Mass Index. Higher values of D-Dimer were related either to a larger extent of lung involvement or late consolidation pattern. In addition, the extent of lung involvement was related with longer hospital stay, higher requirement of mechanical ventilation (HR 0.12, p < 0.01) and mortality rate (HR 0.13, p < 0.01); whereas late consolidation was mainly associated with requirement of mechanical ventilation (HR 0.23, p < 0.01). Conclusion Tomographic extent of lung involvement and the pattern of lung injury are related with coagulopathy severity markers like D-Dimer, and own prognostic clinical ability in ARDS.https://doi.org/10.1186/s12890-025-03531-1Acute respiratory syndromeD-DimerCT-scanCOVID-19Lung injuryGround glass opacity |
| spellingShingle | Juan Antonio Suárez-Cuenca José Fernando Flores-Zaleta Leslie Andrea Corona-Rojas Pablo Guzmán-Rullán Luis Alfonso Camacho-Barajas Uzziel Aguilera-Ontiveros Alberto Melchor-López Alejandro González-Mora Perla Marlene Guzmán-Ramírez Janicia Rodríguez-Solis Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19 BMC Pulmonary Medicine Acute respiratory syndrome D-Dimer CT-scan COVID-19 Lung injury Ground glass opacity |
| title | Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19 |
| title_full | Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19 |
| title_fullStr | Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19 |
| title_full_unstemmed | Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19 |
| title_short | Tomographic features of lung damage associate with D-Dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to COVID-19 |
| title_sort | tomographic features of lung damage associate with d dimer levels and further clinical outcome in patients with acute respiratory distress syndrome due to covid 19 |
| topic | Acute respiratory syndrome D-Dimer CT-scan COVID-19 Lung injury Ground glass opacity |
| url | https://doi.org/10.1186/s12890-025-03531-1 |
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