Is Measuring D-Dimer Helpful in Hospitalized COVID-19 Patients with Suspected PE?

Clinicians have long relied on a normal D-dimer level in conjunction with low-to-moderate clinical prediction scores (e.g., Wells, Geneva) to rule out pulmonary embolism (PE). COVID-19 patients are at excess thrombotic risk, and whether D-dimer measurement is useful in this population is unclear.

Researchers in Florida retrospectively reviewed data on 1500 consecutive patients hospitalized with COVID-19 from January 2020 to February 2021. A total of 287 patients underwent D-dimer testing and computed tomographic pulmonary angiography (CTPA) for evaluation of PE: 37 (13%) had PEs. All positive CTPA patients had elevated D-dimer levels (>500 ng/mL); however, most patients (91%) without imaging-identified PE also had elevated D-dimer levels, al…