We thank Tang et al. for their perspective on the possible limitation of D‐dimer levels guiding anticoagulant treatment in patients with COVID‐19 [1]. Although there is a clear association with elevated D‐dimer and severity of COVID‐19 disease, it is important to highlight the fact that D‐dimer has always been utilised in conjunction with clinical pre‐test probability, as a predictive tool to help exclude a possible diagnosis of venous thromboembolism. It has never been validated to guide clinical treatment or anticoagulation. It has recently been noted that a significant proportion of the recent literature concerning D‐dimer in COVID‐19 is fraught with variable, poor or incomplete reporting which further muddies its role in the management of COVID‐19 related coagulopathy[2].
Fibrinolysis and COVID‐19: a tale of two sites?