Mean Platelet Volume as a Predictor of COVID-19 Severity: A Prospective Cohort Study in the Highlands of Peru

Abstract

Introduction: Although 80% of symptomatic individuals with COVID-19 develop mild forms, it is the severe (15%) and critical (5%) forms that have the greatest impact in the hospital setting. Recognizing markers that can predict severe forms is essential, especially in high-altitude populations. Methods: We conducted a prospective cohort study at 3200 masl (meters above sea level) in a city in Peru to determine if MPV (mean platelet volume) level is a predictor of COVID-19 severity. Patients with mild/moderate disease were enrolled and followed for 21 days or until the development of severe disease (primary outcome). A bivariate analysis was used to identify variables associated with severe disease. A ROC analysis determined the best MPV (mean platelet count) cut-off to predict COVID-19 severity, and then, a multiple regression analysis was performed. Results: 64 patients were enrolled. The median age was 48.5 years (IQT 39–64.5) and the proportion of women was 51.6%, the most frequent symptoms were chest pain (73%), fever (71%), and dyspnea (67%). The median time to develop a severe form from the onset of symptoms was 11 days (IQT 10.5–13). The most common radiographic phase on CT scan (computed tomography) was progressive (60.38%). We observed that an MPV of more than 10.15 fL in the first week of disease predicted severity regardless of age and sex at high altitudes. Conclusions: MPV in the first week of the disease may predict severity in patients diagnosed with COVID-19 at high altitudes; however, we need prospective studies with a larger population and at a different altitude, levels to confirm these findings.

Full Blood Count Parameters in COVID-19 Patients With Disease Severity, Patient Outcome and Vaccination Status

“…It is the main indicator of systemic inflammation and is commonly used to predict patient outcomes in bacterial infections. In severe cases of COVID-19, the white blood cells shift toward neutrophils rather than lymphocytes, indicating that NLR might aid in Whereas our analysis of MPV showed significantly higher in severe and poor outcome patients which supports previous studies (31,32,33). High MPV indicates the presence of increased immature platelets that are functionally, metabolically, and enzymatically active and can cause significant prothrombotic potential.…”

Beyond the Acute Phase: Long-Term Impact of COVID-19 on Functional Capacity and Prothrombotic Risk—A Pilot Study

“…Shape changes, platelet-mediated immunoregulation [44], or changes associated with the activator phenotype are some pathophysiological hypotheses developed so far [45][46][47]. Mean platelet volume [MPV] is a prognostic marker frequently used in association with cardiovascular risk, with higher values associated with prothrombotic and proinflammatory status [48], this biological finding being confirmed in our study as well for the group with pulmonary fibrosis, long-term after COVID-19.…”

Platelet Indices as Novel Surrogate Markers for the Prognosis of COVID-19 Infection: An Observational Study

“…Nevertheless, there was no discernible difference in the mean PCT or PDW across the severity groups. Similar findings were made by Quispe-Pari et al who discovered that those with severe COVID-19 had considerably higher mean MPV [42]. Further research by Yardimci et al [5] and Walinjkar et al [22] showed that PDW did not significantly correlate with the severity of the condition.…”

“…Related to the current investigation, Dubey et al discovered that MPV was the most crucial factor and that death was predicted by values more than 10.05 with a sensitivity and specificity of 69.5% and 69.3%, respectively [46]. In a different research, Quispe-Pari et al used a cut-off of 10.15 and showed a 59% sensitivity and a 14% specificity in forecasting death [42,47]. According to Shah et al, MPV exhibited a sensitivity and precision of 66.3% and 62.8%, respectively, in predicting mortality at a cut-off of 10.45 [48,49].…”