Diagnostic Value of D-Dimer in COVID-19: A Meta-Analysis and Meta-Regression

Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211010976. doi: 10.1177/10760296211010976.


The prognostic role of hypercoagulability in COVID-19 patients is ambiguous. D-dimer, may be regarded as a global marker of hemostasis activation in COVID-19. Our study was to assess the predictive value of D-dimer for the severity, mortality and incidence of venous thromboembolism (VTE) events in COVID-19 patients. PubMed, EMBASE, Cochrane Library and Web of Science databases were searched. The pooled diagnostic value (95% confidence interval [CI]) of D-dimer was evaluated with a bivariate mixed-effects binary regression modeling framework. Sensitivity analysis and meta regression were used to determine heterogeneity and test robustness. A Spearman rank correlation tested threshold effect caused by different cut offs and units in D-dimer reports. The pooled sensitivity of the prognostic performance of D-dimer for the severity, mortality and VTE in COVID-19 were 77% (95% CI: 73%-80%), 75% (95% CI: 65%-82%) and 90% (95% CI: 90%-90%) respectively, and the specificity were 71% (95% CI: 64%-77%), 83% (95% CI: 77%-87%) and 60% (95% CI: 60%-60%). D-dimer can predict severe and fatal cases of COVID-19 with moderate accuracy. It also shows high sensitivity but relatively low specificity for detecting COVID-19-related VTE events, indicating that it can be used to screen for patients with VTE.

Keywords: COVID-19; D-dimer; coronavirus 2019; diagnosis; venous thromboembolism.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 Testing*
  • COVID-19* / blood
  • COVID-19* / complications
  • COVID-19* / diagnosis
  • COVID-19* / mortality
  • Disease-Free Survival
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Humans
  • Incidence
  • Male
  • Predictive Value of Tests
  • SARS-CoV-2 / metabolism*
  • Survival Rate
  • Thromboembolism* / blood
  • Thromboembolism* / diagnosis
  • Thromboembolism* / etiology
  • Thromboembolism* / mortality


  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D