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Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study

Overview of attention for article published in Clinics, January 2021
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (56th percentile)
  • High Attention Score compared to outputs of the same age and source (80th percentile)

Mentioned by

twitter
4 tweeters

Citations

dimensions_citation
1 Dimensions

Readers on

mendeley
15 Mendeley
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Title
Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study
Published in
Clinics, January 2021
DOI 10.6061/clinics/2021/e3547
Pubmed ID
Authors

Fabio Augusto Rodrigues Gonçalves, Bruno Adler Maccagnan Pinheiro Besen, Clarice Antunes de Lima, Aline Pivetta Corá, Antônio José Rodrigues Pereira, Sandro Félix Perazzio, Christiane Pereira Gouvea, Luiz Augusto Marcondes Fonseca, Evelinda Marramon Trindade, Nairo Massakazu Sumita, Alberto José da Silva Duarte, Arnaldo Lichtenstein, Eloisa Bonfa, Edivaldo M. Utiyama, Aluisio C. Segurado, Beatriz Perondi, Anna Miethke-Morais, Amanda C. Montal, Leila Harima, Solange R.G. Fusco, Marjorie F. Silva, Marcelo C. Rocha, Izabel Marcilio, Izabel Cristina Rios, Fabiane Yumi Ogihara Kawano, Maria Amélia de Jesus, Ésper George Kallas, Carolina Carmo, Clarice Tanaka, Heraldo Possolo de Souza, Julio F.M. Marchini, Carlos Carvalho, Juliana C. Ferreira, Anna Sara Shafferman Levin, Maura Salaroli Oliveira, Thaís Guimarães, Carolina dos Santos Lázari, Ester Sabino, Marcello M.C. Magri, Tarcisio E.P. Barros-Filho, Maria Cristina Peres Braido Francisco, Silvia F. Costa

Abstract

Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 15 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 1 7%
Researcher 1 7%
Student > Doctoral Student 1 7%
Student > Master 1 7%
Unknown 11 73%
Readers by discipline Count As %
Unspecified 1 7%
Mathematics 1 7%
Psychology 1 7%
Engineering 1 7%
Unknown 11 73%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 February 2022.
All research outputs
#12,211,087
of 21,240,621 outputs
Outputs from Clinics
#311
of 667 outputs
Outputs of similar age
#190,998
of 450,571 outputs
Outputs of similar age from Clinics
#4
of 15 outputs
Altmetric has tracked 21,240,621 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 667 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one has gotten more attention than average, scoring higher than 53% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 450,571 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 56% of its contemporaries.
We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 80% of its contemporaries.