Association between thrombocytopenia and the severity of Covid-19 infection among hospitalized Egyptian patients

El-Khaiat, Mohsen M; El-Lehlah, Ayman M; Kesheita, Manal A; Abdel‐Samiee, Mohamed; Teima, Ahmed

doi:10.1016/j.amsu.2022.103973

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…These findings suggest that thrombocyte count and aPTT, as individual predictors, did not have good accuracies. These findings are in contradiction with previous studies which reported the association between thrombocytopenia and COVID-19 severity [40][41][42][43][44]. In a previous study, a series of thrombocyte count laboratory tests was performed three times during hospitalization (on 1 st , 3 rd , and 6 th day of admission) [42].…”

Section: Discussioncontrasting

confidence: 74%

Hemostatic and liver function parameters as COVID-19 severity markers

Iqbal,

Mudatsir,

Harapan

et al. 2024

Narra J

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a disease newly discovered in December 2019 which affects coagulation cascade and liver functions. The aim of this study was to investigate the potential of hemostatic and liver function parameters as severity markers in COVID-19 patients. This study was an observational analytic with cohort retrospective design using total sampling method. Data were retrieved from medical record of COVID-19 patients admitted to provincial hospital in Banda Aceh, Indonesia from March 2020 to March 2022. There were 1208 data eligible for the study after applying certain criteria. Mann–Whitney, logistic regression, and receiving operating characteristic (ROC) analyses were used to analysis the data. Thrombocyte count (p<0.001), prothrombin time (p<0.001), activated partial thromboplastin time (p<0.001), D-dimer (p<0.001), fibrinogen (p<0.001), aspartate aminotransferase (p<0.001), and alanine transaminase (p<0.001) significantly increased in severe compared to mild COVID-19 patients. After being adjusted, age (odds ratio (OR); 1.026 (95% confidence interval (CI): 1.016–1.037) was the most significant factor in predicting COVID-19 severity. Fibrinogen (cut-off 526.5 mg/L) was the best parameter associated with COVID-19 severity with 70% sensitivity and 66.4% specificity. Meanwhile, D-dimer (cut-off 805 ng/mL) had a sensitivity of 72.3% and specificity of 66.4%. Combining the parameters resulted in improved sensitivity to 82.0% with a slight decline of specificity to 65.5%. In conclusion, fibrinogen and D-dimer level on admission could be used as biomarkers in predicting COVID-19 prognosis. Routine monitoring and evaluation of laboratory testing especially D-dimer and fibrinogen could be implemented in order to reduce morbidity and mortality rate of COVID-19.

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Section: Discussioncontrasting

confidence: 74%

Hemostatic and liver function parameters as COVID-19 severity markers

Iqbal,

Mudatsir,

Harapan

et al. 2024

Narra J

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“…Thrombocytopenia is a common feature of various infectious and non-infectious conditions and can be associated with different degrees of organ dysfunction and severity of illness. Our study observed a significant association between the degree of thrombocytopenia and organ dysfunction, shock, and third space loss [ 17 ]. Patients with moderate and severe thrombocytopenia had higher rates of organ dysfunction, shock, and third-space loss than those with mild thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Etiological Profile of Acute Undifferentiated Fever With Thrombocytopenia in an Emergency Department

Dev,

Kumar,

Kumar

et al. 2023

Cureus

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Introduction: Acute undifferentiated fever with thrombocytopenia is a common and challenging clinical presentation encountered in the emergency departments of tertiary care centers, particularly in tropical regions, often requiring prompt evaluation and management. The study aimed to explore the clinical and etiological profile of acute undifferentiated fever with thrombocytopenia in the Emergency Department of Indira Gandhi Institute of Medical Sciences, Patna. It investigates factors associated with patient outcomes and compares platelet transfusion requirements among different etiological groups. Methods: In this cross-sectional observational study, 350 patients with acute undifferentiated fever with thrombocytopenia were analyzed for one year from October '21 to September '22. Pre-existing chronic infectious diseases, liver cirrhosis, and autoimmune conditions were excluded. Results: Thrombocytopenia was observed in all patients, with 65% having platelet counts below 50,000/µL. Associations were found between the degree of thrombocytopenia and organ dysfunction, shock, and third space loss. Logistic regression analysis identified thrombocytopenia, organ dysfunction, and platelet transfusion requirement as significant predictors of the overall outcome. Etiological group comparisons revealed higher platelet transfusion requirements in the bacterial group. Conclusion: Prompt recognition and management of thrombocytopenia in acute undifferentiated fever are vital. Thrombocytopenia, along with organ dysfunction and shock, significantly influence patient outcomes. Tailored interventions based on etiological factors are crucial. Further research should focus on specific viral aetiologies in acute undifferentiated fever with thrombocytopenia.

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“…Numerous studies expound that the platelets of COVID-19 patients appear to be over-reactive and may interact with SARS-CoV-2 to promote coagulation dysfunction during COVID-19 infection [ 10 , 11 , 12 , 13 ]. Multiple lines of evidence listed platelet counting as economic, ubiquitous, and ephemeral in discriminating the COVID-19 into severe/moderate as thrombocytopenia is linked to severe COVID-19 [ 12 , 14 , 15 , 16 , 17 , 18 ]. Autopsies of COVID-19 patients have shown that platelet-rich thrombi exist in the microcapillaries of multiple organs.…”

Section: Introductionmentioning

confidence: 99%

Clinical Value of Platelets and Coagulation Parameters in Predicting the Severity of Delta Variant SARS-CoV-2

Chen

Ren

et al. 2023

Pathobiology

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Introduction: The present study aimed to analyze the clinical features and laboratory markers of patients with Delta variant SARS-CoV-2 and explore the role of platelet in predicting the severity of Delta. Methods: This retrospective, observational study was conducted on 863 patients laboratory-confirmed Delta variant SARS-CoV-2. These cases were sub-classified based on disease severity into mild (n = 304), moderate (n = 537), and severe (n = 22). A series of laboratory findings and clinical data were collected and analyzed during hospitalization. Results: Of 863 hospitalized patients with Delta, the median age was 38 years (interquartile range, 30–51 years) and 471 (54.58%) were male. The most common clinical symptoms mainly included cough, fever, pharyngalgia, expectoration, dyspnea, fatigue, and headache, and the commonest comorbidities were hypertension and diabetes. Among the hematological variables, neutrophil count, red blood cell count, and hemoglobin, were found to be statistically significant with regard to subcategories based of disease severity (p < 0.05). Among coagulation parameters, there was a statistically significant difference in D-dimer, fibrinogen, international normalized ratio, and prothrombin time (p < 0.05). Statistically significant differences were observed in platelet markers including platelet count, large platelet count, and plateletcrit (p < 0.05). Additionally, there was strong correlation between platelet and other parameters with disease severity. Logistical regression analysis and ROC curves showed that D-dimer was a single best marker of disease severity (p = 0.005, p < 0.0001); however, platelet (p = 0.009, p = 0.002) and plateletcrit (p = 0.002, p = 0.001) could also predict severe disease. Platelet was identified as an independent risk factor for severe Delta. Conclusion: Low platelet may be a marker of disease severity in Delta variant SARS-CoV-2 and may contribute to determine the severity of patients infected with Delta.

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Association between thrombocytopenia and the severity of Covid-19 infection among hospitalized Egyptian patients

Cited by 4 publications

References 34 publications

Hemostatic and liver function parameters as COVID-19 severity markers

Hemostatic and liver function parameters as COVID-19 severity markers

Clinical and Etiological Profile of Acute Undifferentiated Fever With Thrombocytopenia in an Emergency Department

Clinical Value of Platelets and Coagulation Parameters in Predicting the Severity of Delta Variant SARS-CoV-2

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