D-DIMER LEVELS AND THEIR IMPACT ON PREDICTING COVID-19 DISEASE PROGRESSION: A RETROSPECTIVE STUDY AT DIAGNOSTIC LABORATORY, ZIMBABWE

Lenah Shumba; Emmanuel Ifeanyi Obeagu

doi:10.22270/ujpr.v11i5.1661

Lenah Shumba Division of Haematology, Department of Biomedical and Laboratory Science, Africa University, Zimbabwe.
Emmanuel Ifeanyi Obeagu Division of Haematology, Department of Biomedical and Laboratory Science, Africa University, Zimbabwe. Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Department of Haematology and Immunohaematology, Bahir Dar University, Bahir Dar, Ethiopia.

10.22270/ujpr.v11i5.1661

Keywords:

COVID-19, D-dimer, coagulation, disease severity, Zimbabwe

Abstract

Background: Coronavirus disease 2019 (COVID-19) is frequently complicated by coagulation abnormalities, with elevated D-dimer levels consistently associated with severe disease and poor clinical outcomes. Evidence from sub-Saharan Africa, particularly Zimbabwe, remains limited despite the clinical relevance of this biomarker in resource-limited settings.

Objective: To evaluate the impact of D-dimer levels on predicting COVID-19 disease progression among patients tested at a diagnostic laboratory in Zimbabwe between December 2019 and December 2020.

Methods: This retrospective observational study reviewed records of 99 patients with laboratory-confirmed COVID-19 who had documented D-dimer results. Demographic data, D-dimer levels, patient ward location, and indicators of disease severity were analyzed. Severe COVID-19 was defined as admission to a high-dependency unit (HDU) or intensive care unit (ICU). Statistical analyses included descriptive statistics, comparison across age groups and wards, receiver operating characteristic (ROC) curve analysis, and logistic regression to assess the predictive value of D-dimer.

Results: The mean age of patients was 68.04±20.37 years, with a slight female predominance (53.54%). The overall mean D-dimer level was 1.48±2.76 μg/mL. Higher D-dimer concentrations were observed in older age groups and in patients admitted to HDU and ICU. ROC curve analysis demonstrated good discriminatory performance of D-dimer in predicting severe COVID-19. Logistic regression showed a positive association between increasing D-dimer levels and the probability of severe disease.

Conclusion: Elevated D-dimer levels are strongly associated with COVID-19 disease severity and progression in this Zimbabwean cohort. D-dimer is a valuable and accessible prognostic biomarker that can support early risk stratification and clinical decision-making in resource-constrained healthcare settings.

Peer Review History:

Received 23 July 2026; Reviewed 7 September 2026; Accepted 5 October; Available online 15 November 2026

Academic Editor: Dr. Emmanuel O. Olorunsola, Department of Pharmaceutics & Pharmaceutical Technology, University of Uyo, Nigeria, [email protected]