Interest of D-dimer level,severity of COVID-19 and cost of management in Gabon  

作　　者：Berthe A Iroungou Arnaud Nze O Helga M Kandet Y Neil-Michel Longo-Pendy Nina D Mezogho-Obame Annicet-Clotaire Dikoumba Guignali L Mangouka 

机构地区：[1]UnitéMixte de Recherche,Centre International de Recherches Médicales de Franceville et le Service de SantéMilitaire,Libreville 20404,Estuaire,Gabon [2]AP-HP Health Economics,Research Unit,Htel Dieu Hospital,Paris 75004,Ilede-France,France [3]Laboratory,Hôpital D'Instruction des Armées D'Akanda,Libreville 20404,Estuaire,Gabo [4]Unitéde Recherche enÉcologie de la Santé,Centre Interdisciplinaire de Recherches Médicales de Franceville,Franceville 769,Gabon [5]Laboratory,Hôpital D'Instruction des Armées Omar Bongo Ondimba,Libreville 20404,Estuaire,Gabon [6]Department of Medecine Polyvalente,Hôpital D'Instruction des Armées Omar Bongo Ondimba,Libreville 20404,Estuaire,Gabon

出　　处：《World Journal of Critical Care Medicine》2025年第1期91-99,共9页世界重症医学杂志（英文）

摘　　要：BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.

关 键 词：D-DIMERS COVID-19 MANAGEMENT Disease severity Healthcare costs GABON 

分 类 号：R722.131[医药卫生—儿科]