{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:21:19Z","timestamp":1790824879185,"version":"4.1.0"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Groupe Hospitalier Paris Saint Joseph"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>\n            Objective\u2003D-dimer measurement is a safe tool to exclude pulmonary embolism (PE), but its specificity decreases in coronavirus disease 2019 (COVID-19) patients. Our aim was to derive a new algorithm with a specific D-dimer threshold for COVID-19 patients.<\/jats:p><jats:p>\n            Methods\u2003We conducted a French multicenter, retrospective cohort study among 774 COVID-19 patients with suspected PE. D-dimer threshold adjusted to extent of lung damage found on computed tomography (CT) was derived in a patient set (n\u2009=\u2009337), and its safety assessed in an independent validation set (n\u2009=\u2009337).<\/jats:p><jats:p>\n            Results\u2003According to receiver operating characteristic curves, in the derivation set, D-dimer safely excluded PE, with one false negative, when using a 900\u2009ng\/mL threshold when lung damage extent was &lt;50% and 1,700\u2009ng\/mL when lung damage extent was \u226550%. In the derivation set, the algorithm sensitivity was 98.2% (95% confidence interval [CI]: 94.7\u2013100.0) and its specificity 28.4% (95% CI: 24.1\u201332.3). The negative likelihood ratio (NLR) was 0.06 (95% CI: 0.01\u20130.44) and the area under the curve (AUC) was 0.63 (95% CI: 0.60\u20130.67). In the validation set, sensitivity and specificity were 96.7% (95% CI: 88.7\u201399.6) and 39.2% (95% CI: 32.2\u201346.1), respectively. The NLR was 0.08 (95% CI; 0.02\u20130.33), and the AUC did not differ from that of the derivation set (0.68, 95% CI: 0.64\u20130.72, p\u2009=\u20090.097). Using the Co-LEAD algorithm, 76 among 250 (30.4%) COVID-19 patients with suspected PE could have been managed without CT pulmonary angiography (CTPA) and 88 patients would have required two CTs.<\/jats:p><jats:p>\n            Conclusion\u2003The Co-LEAD algorithm could safely exclude PE, and could reduce the use of CTPA in COVID-19 patients. Further prospective studies need to validate this strategy.<\/jats:p>","DOI":"10.1055\/a-1768-4371","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:01:32Z","timestamp":1644537692000},"page":"1888-1898","source":"Crossref","is-referenced-by-count":9,"title":["Adjusting D-dimer to Lung Disease Extent to Exclude Pulmonary Embolism in COVID-19 Patients (Co-LEAD)"],"prefix":"10.1055","volume":"122","author":[{"given":"Benjamin","family":"Planquette","sequence":"first","affiliation":[{"name":"Innovative Therapies in Haemostasis, Universit\u00e9 de Paris, INSERM, Paris, France"},{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"Department of Respiratory Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"F-CRIN INNOVTE, Saint-\u00c9tienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Khider","sequence":"first","affiliation":[{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"Department of Vascular Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"Physics for Medicine Paris, INSERM U1273, ESPCI Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Le","family":"Berre","sequence":"first","affiliation":[{"name":"Department of Radiology, Groupe Hospitalier Paris Saint-Joseph, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Soudet","sequence":"first","affiliation":[{"name":"EA7516 CHIMERE and Service de M\u00e9decine Vasculaire, Universit\u00e9 Picardie Jules Verne, CHU Amiens-Picardie, Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Pernod","sequence":"first","affiliation":[{"name":"Service Universitaire de M\u00e9decine Vasculaire, CHU de Grenoble-Alpes, Universit\u00e9 Grenoble-Alpes, CNRS\/TIMC-IMAG UMR 5525\/Th\u00e8mas 38043 Grenoble, F-CRIN INNOVTE, Saint-\u00c9tienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rapha\u00ebl Le","family":"Mao","sequence":"first","affiliation":[{"name":"D\u00e9partement de M\u00e9decine Interne et Pneumologie, Centre Hospitalo-Universitaire de Brest, Universit\u00e9 de Bretagne Occidentale, EA 3878, CIC INSERM 1412, Brest, F-CRIN INNOVTE, Saint-\u00c9tienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Besutti","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospital, Besan\u00e7on, EA3920, University of Burgundy Franche Comt\u00e9, Besan\u00e7on, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Gendron","sequence":"additional","affiliation":[{"name":"Innovative Therapies in Haemostasis, Universit\u00e9 de Paris, INSERM, Paris, France"},{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"F-CRIN INNOVTE, Saint-\u00c9tienne, France"},{"name":"Department of Haematology, Assistance Publique H\u00f4pitaux de Paris.Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Yanoutsos","sequence":"additional","affiliation":[{"name":"Department of vascular medicine, Groupe hospitalier Paris Saint Joseph, Paris, France"},{"name":"Department of Vascular Medicine, INSERM CRESS UMR 1153, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Smadja","sequence":"additional","affiliation":[{"name":"Department of Radiology, Universit\u00e9 de Paris, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Goudot","sequence":"additional","affiliation":[{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"Department of Vascular Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"Physics for Medicine Paris, INSERM U1273, ESPCI Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma Al","family":"Kahf","sequence":"additional","affiliation":[{"name":"Innovative Therapies in Haemostasis, Universit\u00e9 de Paris, INSERM, Paris, France"},{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"Department of Respiratory Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"F-CRIN INNOVTE, Saint-\u00c9tienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nassim","family":"Mohamedi","sequence":"additional","affiliation":[{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"Department of Vascular Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"Physics for Medicine Paris, INSERM U1273, ESPCI Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine Al","family":"Hamoud","sequence":"additional","affiliation":[{"name":"Innovative Therapies in Haemostasis, Universit\u00e9 de Paris, INSERM, Paris, France"},{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"Department of Respiratory Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"F-CRIN INNOVTE, Saint-\u00c9tienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lien","family":"Philippe","sequence":"additional","affiliation":[{"name":"Innovative Therapies in Haemostasis, Universit\u00e9 de Paris, INSERM, Paris, France"},{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"F-CRIN INNOVTE, Saint-\u00c9tienne, France"},{"name":"Department of Haematology, Assistance Publique H\u00f4pitaux de Paris.Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Fournier","sequence":"additional","affiliation":[{"name":"Department of Radiology, Universit\u00e9 de Paris, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastien","family":"Rance","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Universit\u00e9 de Paris, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Diehl","sequence":"additional","affiliation":[{"name":"Innovative Therapies in Haemostasis, Universit\u00e9 de Paris, INSERM, Paris, France"},{"name":"Biosurgical Research Lab (Carpentier Foundation), Universit\u00e9 de Paris, Paris, France"},{"name":"Intensive Care Unit, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Mirault","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"Department of Emergency, Universit\u00e9 de Paris, PARCC, INSERM, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Messas","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Assistance Publique H\u00f4pitaux de Paris, Centre-Universit\u00e9 de Paris (APHP-CUP), Paris, France"},{"name":"Department of Radiology, Groupe Hospitalier Paris Saint-Joseph, Paris, France"},{"name":"Department of Vascular Medicine, Paris Research Cardiovascular Center, PARCC, INSERM UMR-S 970, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Emmerich","sequence":"additional","affiliation":[{"name":"Department of vascular medicine, Groupe hospitalier Paris Saint Joseph, Paris, France"},{"name":"Department of Vascular Medicine, INSERM 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Antoinette","family":"Sevestre","sequence":"additional","affiliation":[{"name":"EA7516 CHIMERE and Service de M\u00e9decine Vasculaire, Universit\u00e9 Picardie Jules Verne, CHU Amiens-Picardie, Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Meneveau","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital, Besan\u00e7on, EA3920, University of Burgundy Franche Comt\u00e9, Besan\u00e7on, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Chatellier","sequence":"additional","affiliation":[{"name":"Department of Statistics, Bioinformatics and Public Health, INSERM CIC 14-18, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Innovative Therapies in Haemostasis, Universit\u00e9 de Paris, INSERM, Paris, France"},{"name":"Biosurgical Research Lab (Carpentier 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