How artificial intelligence during the pandemic modified the role of a biomarker as d-dimer

Published: 20 November 2023
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Artificial intelligence (AI) was introduced in medicine to make some difficult decision-making regarding diagnostics and/or treatments easy. Its application derives from the improvement of information obtained with computer sciences and informatics, in particular with information derived by algorithms obtained with special informatics support as machine learning. The scenario of hospital changes induced by the COVID-19 pandemic makes easy the application of AI for some clinical updates. Being lung failure with pulmonary embolism is the most common cause of death for inpatients with COVID-19, some biomarkers such as the d-dimer are constantly used associated with other clinical features in order to improve medical assistance. For this reason, d-dimer during the pandemic changed its traditional use for predictive negative value in patients with suspected pulmonary embolism and took relevance for its values giving the chance to change the intensity of anticoagulation for several inpatients. In most cases, according to data reported from several cohorts, these changes improved the morbidity and mortality of a significant percentage of inpatients with COVID-19. The International medical prevention registry on venous thromboembolism and d-dimer and modified sepsis-induced coagulopathy scores were the most used scores derived from AI and dedicated to these clinical aspects in inpatients with COVID-19. Therefore, this review was dedicated to flexible changes that we can use after d-dimer values in different clinical scenarios that vary from disseminated intravascular coagulation to pulmonary embolism to COVID-19.

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Kulikowski CA. Beginnings of Artificial Intelligence in Medicine (AIM): Computational Artifice Assisting Scientific Inquiry and Clinical Art - with Reflections on Present AIM Challenges. Yearb Med Inform 2019;28:249-56 DOI: https://doi.org/10.1055/s-0039-1677895
Ponti G, Maccaferri M, Ruini C, et al. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci 2020;57:389-99. DOI: https://doi.org/10.1080/10408363.2020.1770685
Favresse J, Lippi G, Roy PM, et al. D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications. Crit Rev Clin Lab Sci 2018;55:548-77. DOI: https://doi.org/10.1080/10408363.2018.1529734
Eljilany I, Elzouki AN. D-Dimer, Fibrinogen, and IL-6 in COVID-19 Patients with Suspected Venous Thromboembolism: A Narrative Review. Vasc Health Risk Manag 2020;16:455-62. DOI: https://doi.org/10.2147/VHRM.S280962
Saxena R, Gupta PK, Ahmed R, et al. D-dimer test: diagnostic role in clinical and sub-clinical DIC. Indian J Pathol Microbiol 2003;46:425-6.
Giaccherini C, Verzeroli C, Russo L, et al. Thrombin Generation and D-Dimer for Prediction of Disease Progression and Mortality in Patients with Metastatic Gastrointestinal Cancer. Cancers (Basel) 2022;14:4347. DOI: https://doi.org/10.3390/cancers14184347
Di Micco P, D'Uva M, Strina I, et al. The role of d-dimer as first marker of thrombophilia in women affected by sterility: implications in pathophysiology and diagnosis of thrombophilia induced sterility. J Transl Med 2004;2:38.
Pastorelli L, Dozio E, Pisani LF, et al. Procoagulatory state in inflammatory bowel diseases is promoted by impaired intestinal barrier function. Gastroenterol Res Pract 2015;2015:189341. DOI: https://doi.org/10.1155/2015/189341
Shi A, Huang J, Wang X, et al. Postoperative D-dimer predicts venous thromboembolism in patients undergoing urologic tumor surgery. Urol Oncol 2018;36:307. DOI: https://doi.org/10.1016/j.urolonc.2018.03.003
Avnery O, Martin M, Bura-Riviere A, et al. D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry. J Intern Med 2020;287:32-41. DOI: https://doi.org/10.1111/joim.12969
Wang Y, Hafeez A, Meng F, et al. The correlation of D-dimer levels with patient outcomes in acute ischemic cerebrovascular disease complicating coronary heart disease. Neurol Res 2016;38:524-32. DOI: https://doi.org/10.1080/01616412.2016.1187829
Townsend L, Fogarty H, Dyer A, et al. Prolonged elevation of D-dimer levels in convalescent COVID-19 patients is independent of the acute phase response. J Thromb Haemost 2021;19:1064-70. DOI: https://doi.org/10.1111/jth.15267
Konstantinides SV, Meyer G. The 2019 ESC Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism. Eur Heart J 2019;40:3453-5. DOI: https://doi.org/10.1093/eurheartj/ehz726
Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol 2009;145:24-33.
Grau E, Tenías JM, Soto MJ, et al. D-dimer levels correlate with mortality in patients with acute pulmonary embolism: Findings from the RIETE registry. Crit Care Med 2007;35:1937-41. DOI: https://doi.org/10.1097/01.CCM.0000277044.25556.93
May JE, Wolberg AS, Lim MY. Disorders of Fibrinogen and Fibrinolysis. Hematol Oncol Clin North Am 2021;35:1197-217. DOI: https://doi.org/10.1016/j.hoc.2021.07.011
Olson JD. D-dimer: An Overview of Hemostasis and Fibrinolysis, Assays, and Clinical Applications. Adv Clin Chem 2015;69:1-46. DOI: https://doi.org/10.1016/bs.acc.2014.12.001
Liu Q, Chen L, Wang Z, et al. The role of D-dimer and fibrinogen testing in catheter-directed thrombolysis with urokinase for deep venous thrombosis. Phlebology 2023;38:389-97. DOI: https://doi.org/10.1177/02683555231176911
Asakura H, Takahashi H, Uchiyama T, et al. Proposal for new diagnostic criteria for DIC from the Japanese Society on Thrombosis and Hemostasis. Thromb J 2016;14:42. DOI: https://doi.org/10.1186/s12959-016-0117-x
Grafeneder J, Buchtele N, Egger D, et al. Disseminated Intravascular Coagulation Score Predicts Mortality in Patients with Liver Disease and Low Fibrinogen Level. Thromb Haemost 2022;122:1980-7. DOI: https://doi.org/10.1055/a-1925-2300
Iba T, Connors JM, Nagaoka I, Levy JH. Recent advances in the research and management of sepsis-associated DIC. Int J Hematol 2021;113:24-33. DOI: https://doi.org/10.1007/s12185-020-03053-y
Ten Cate H, Leader A. Management of Disseminated Intravascular Coagulation in Acute Leukemias. Hamostaseologie 2021;41:120-6. DOI: https://doi.org/10.1055/a-1393-8302
Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol 2009;145:24-33. DOI: https://doi.org/10.1111/j.1365-2141.2009.07600.x
Buaboonnam J, Wangkittikal C, Narkbunnam N, et al. Outcomes of Overt and Non-overt Disseminated Intravascular Coagulation Using the ISTH DIC Scoring System in Children: A Single-Center Study. Mediterr J Hematol Infect Dis 2023;15:e2023004. DOI: https://doi.org/10.4084/MJHID.2023.004
Hager K, Platt D. Fibrin degeneration product concentrations (D-dimers) in the course of ageing. Gerontology 1995;41:159-65. DOI: https://doi.org/10.1159/000213677
Righini M, Van Es J, Den Exter PL, et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study. JAMA 2014;311:1117-24. DOI: https://doi.org/10.1001/jama.2014.2135
Schutte T, Thijs A, Smulders YM. Never ignore extremely elevated D-dimer levels: they are specific for serious illness. Neth J Med 2016;74:443-8.
Ma M, Cao R, Wang W, et al. The D-dimer level predicts the prognosis in patients with lung cancer: a systematic review and meta-analysis. J Cardiothorac Surg 2021;16:243. DOI: https://doi.org/10.1186/s13019-021-01618-4
Tomimaru Y, Yano M, Takachi K, et al. Correlation between pretherapeutic d-dimer levels and response to neoadjuvant chemotherapy in patients with advanced esophageal cancer. Dis Esophagus 2008;21:281-7. DOI: https://doi.org/10.1111/j.1442-2050.2007.00758.x
Owczarek D, Cibor D, Sałapa K, et al. Reduced plasma fibrin clot permeability and susceptibility to lysis in patients with inflammatory bowel disease: a novel prothrombotic mechanism. Inflamm Bowel Dis 2013;19:2616-24.
Owczarek D, Cibor D, Sałapa K, et al. Reduced plasma fibrin clot permeability and susceptibility to lysis in patients with inflammatory bowel disease: a novel prothrombotic mechanism. Inflamm Bowel Dis 2013;19:2616-24. DOI: https://doi.org/10.1097/01.MIB.0000437041.59208.44
Becker RC, Alexander JH, Newby LK, et al. Effect of apixaban, an oral and direct factor Xa inhibitor, on coagulation activity biomarkers following acute coronary syndrome. Thromb Haemost 2010;104:976-83. DOI: https://doi.org/10.1160/TH10-04-0247
Yao J, Bai T, Yang B, Sun L. The diagnostic value of D-dimer in acute aortic dissection: a meta-analysis. J Cardiothorac Surg 2021;16:343. DOI: https://doi.org/10.1186/s13019-021-01726-1
Bellesini M, Robert-Ebadi H, Combescure C, et al. D-dimer to rule out venous thromboembolism during pregnancy: A systematic review and meta-analysis. J Thromb Haemost 2021;19:2454-67. DOI: https://doi.org/10.1111/jth.15432
Shao H, Gao S, Dai D, et al. The association of antenatal D-dimer and fibrinogen with postpartum hemorrhage and intrauterine growth restriction in preeclampsia. BMC Pregnancy Childbirth 2021;21:605. DOI: https://doi.org/10.1186/s12884-021-04082-z
Di Micco P, D'Uva M, Strina I, et al. The role of d-dimer as first marker of thrombophilia in women affected by sterility: implications in pathophysiology and diagnosis of thrombophilia induced sterility. J Transl Med 2004;2:38. DOI: https://doi.org/10.1186/1479-5876-2-38
Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020;41:543-603. DOI: https://doi.org/10.1093/eurheartj/ehz405
Shen JH, Chen HL, Chen JR, et al. Comparison of the Wells score with the revised Geneva score for assessing suspected pulmonary embolism: a systematic review and meta-analysis. J Thromb Thrombolysis 2016;41:482-92. DOI: https://doi.org/10.1007/s11239-015-1250-2
Dempfle CE. Validation, calibration, and specificity of quantitative D-dimer assays. Semin Vasc Med 2005;5:315-20. DOI: https://doi.org/10.1055/s-2005-922476
Lobo JL, Zorrilla V, Aizpuru F, et al. D-dimer levels and 15-day outcome in acute pulmonary embolism. Findings from the RIETE Registry. J Thromb Haemost 2009;7:1795-801. DOI: https://doi.org/10.1111/j.1538-7836.2009.03576.x
Maestre A, Trujillo-Santos J, Visoná A, et al. D-dimer levels and 90-day outcome in patients with acute pulmonary embolism with or without cancer. Thromb Res 2014;133:384-9. DOI: https://doi.org/10.1016/j.thromres.2013.12.044
Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020;191:145-7. DOI: https://doi.org/10.1016/j.thromres.2020.04.013
Di Micco P, Russo V, Lodigiani C. Venous Thromboembolism and Its Association with COVID-19: Still an Open Debate. Medicina (Kaunas) 2020;56:506. DOI: https://doi.org/10.3390/medicina56100506
Cuker A, Tseng EK, Nieuwlaat R, et al. American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19. Blood Adv 2021;5:872-88. DOI: https://doi.org/10.1182/bloodadvances.2020003763
Helmy MA, Milad LM, Hasanin A, et al. Ability of IMPROVE and IMPROVE-DD scores to predict outcomes in patients with severe COVID-19: a prospective observational study. Sci Rep 2022;12:13323. DOI: https://doi.org/10.1038/s41598-022-17466-8
Kapoor M, Panda PK, Saini LK, Bahurupi Y. Disseminated Intravascular Coagulation Score and Sepsis-induced Coagulopathy Score in Prediction of COVID-19 Severity: A Retrospective Analysis. Indian J Crit Care Med 2021;25:1357-63. DOI: https://doi.org/10.5005/jp-journals-10071-24056
Lippi G, Mullier F, Favaloro EJ. D-dimer: old dogmas, new (COVID-19) tricks. Clin Chem Lab Med 2022;61:841-50. DOI: https://doi.org/10.1515/cclm-2022-0633
Al-Samkari H, Karp Leaf RS, Dzik WH, et al. COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection. Blood 2020;136:489-500. DOI: https://doi.org/10.1182/blood.2020006520
Di Micco P, Tufano A, Cardillo G, et al. The Impact of Risk-Adjusted Heparin Regimens on the Outcome of Patients with COVID-19 Infection. A Prospective Cohort Study. Viruses 2021;13:1720. DOI: https://doi.org/10.3390/v13091720
Cosmi B, Legnani C, Cini M, et al. D-dimer and residual vein obstruction as risk factors for recurrence during and after anticoagulation withdrawal in patients with a first episode of provoked deep-vein thrombosis. Thromb Haemost 2011;105:837-45. DOI: https://doi.org/10.1160/TH10-08-0559

How to Cite

Di Micco, P., Bernardi, F. F., Fusco, G. M., & Perrella, A. (2023). How artificial intelligence during the pandemic modified the role of a biomarker as d-dimer. Italian Journal of Medicine, 17(3). https://doi.org/10.4081/itjm.2023.1656