D-dimer level in COVID-19 infection: a systematic review

Expert Rev Hematol. 2020 Nov;13(11):1265-1275. doi: 10.1080/17474086.2020.1831383. Epub 2020 Oct 12.


Introduction: COVID-19 disease has spread worldwide from December 2019 to the present day; the early stage of this disease can be associated with high D-dimer, prolonged PT, and elevated levels of fibrinogen, indicating activation of coagulation pathways and thrombosis. In this article, we analyze the levels of D-dimer in patients with COVID-19.

Area covered: In the current study, three databases, PubMed, Scopus, Web of Science, searched using related keywords and information extracted from articles such as location, sample size, gender, age, coagulation test values, patient results, and disease severity.

Expert opinion: D-dimer level is one of the measures used in patients to detect thrombosis. Studies have reported an increase in D-dimer and fibrinogen concentrations in the early stages of COVID-19 disease a 3 to 4-fold rise in D-dimer levels is linked to poor prognosis. In addition, underlying diseases such as diabetes, cancer, stroke, and pregnancy may trigger an increase in D-dimer levels in COVID-19 patients. Measuring the level of D-dimer and coagulation parameters from the early stage of the disease can also be useful in controlling and managing of COVID-19 disease.

Keywords: COVID-19; D-dimer; SARS-CoV-2; coagulopathy; coronavirus.

Publication types

  • Systematic Review

MeSH terms

  • Biomarkers / blood
  • COVID-19 / blood*
  • COVID-19 / virology
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Humans
  • Prognosis
  • SARS-CoV-2 / isolation & purification


  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D