Platelets in the perspective of COVID-19; pathophysiology of thrombocytopenia and its implication as prognostic and therapeutic opportunity

Delshad, Mahda; Safaroghli‐Azar, Ava; Pourbagheri‐Sigaroodi, Atieh; Poopak, Behzad; Shokouhi, Shervin; Bashash, Davood

doi:10.1016/j.intimp.2021.107995

Cited by 37 publications

(33 citation statements)

References 153 publications

(171 reference statements)

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“…Production of autoantibody against PLT glycoproteins also destructs autoantibody-coated PLTs by the reticuloendothelial system leading to thrombocytopenia. 30 A similar findings were reported in Turkey (25.1%), 31 China (17.8%), 32 Iran (30%) 33 and USA (20%). 26 …”

Section: Discussionsupporting

confidence: 74%

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Baseline Thrombocytopenia and Disease Severity Among COVID-19 Patients, Tibebe Ghion Specialized Hospital COVID-19 Treatment Center, Northwest Ethiopia

Asrie¹,

Tekle²,

Gelaw³

et al. 2022

JBM

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Background Thrombocytopenia and platelet indices in COVID-19 patients were important for prompt treatment and management of the disease. Therefore, the main objective of this study was to assess the prevalence of thrombocytopenia, platelet indices, and its association with disease severity among COVID-19 patients at the Tibebe Ghion Specialized Hospital, COVID-19 treatment center, Northwest Ethiopia. Methods A cross-sectional study was conducted among 117 conveniently recruited COVID-19 patients from March to June 2021. Socio-demographic and clinical data were collected using a structured questionnaire and checklist, respectively. The platelet parameters were analyzed by the Mindray-BC 5800 automated hematological analyzer. ANOVA and Kruskal–Wallis tests were used to compare the difference between parametric and non-parametric continuous variables, respectively. Binary logistic regression was used to identify the factors associated with thrombocytopenia. A P-value < 0.05 was defined as statistically significant for all statistical tests. Results Among COVID-19 patients, 45, 43 and 29 were mild, moderate and severe, respectively. 65.8% of the patients were males and 34.2% were alcohol drinkers with a mean age of 50.6 ± 15.4. Moreover, 44.4% of the patients had co-morbidity. Thrombocytopenia was presented in 23.9% of the patients. It was 4.57 (95% CI: 1.30–16.07) and 6.10 (95% CI: 1.54–24.08) times more likely in the moderate and severe cases compared to mild cases, respectively. Disease severity was also associated with PDW (P-value = 0.001). Conclusion Even though thrombocytopenia was not presented in most moderate and severe COVID-19 patients, thrombocytopenia and PDW were associated with disease severity.

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Section: Discussionsupporting

confidence: 74%

“…Thrombocytopenia can prolong hospitalization, increase the need of ventilation, and increase patient mortality. 24 …”

Section: Discussionmentioning

confidence: 99%

Baseline Thrombocytopenia and Disease Severity Among COVID-19 Patients, Tibebe Ghion Specialized Hospital COVID-19 Treatment Center, Northwest Ethiopia

Asrie¹,

Tekle²,

Gelaw³

et al. 2022

JBM

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“…COVID-19 patients present a wide range of clinical conditions, ranging from asymptomatic infections, minimal symptoms (the majority of patients) to fatal respiratory distress (ARDS) [ 1 ]. Data in published literature have shown that about a quarter of COVID-19 infected patients experienced thrombocytopenia and about half of these patients succumb to infection due to coagulopathy [ 3 , 4 ]. The mechanisms leading to thrombocytopenia are not yet well known.…”

Section: Introductionmentioning

confidence: 99%

Platelet Count in Patients with SARS-CoV-2 Infection: A Prognostic Factor in COVID-19

Boccatonda

D’Ardes

Rossi

et al. 2022

JCM

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COVID-19 patients may manifest thrombocytopenia and some of these patients succumb to infection due to coagulopathy. The aim of our study was to examine platelet count values in patients infected with SARS-CoV-2, comparing them to a control group consisting of non-COVID-19 patients. Moreover, we evaluated the correlation between the platelet value and the respiratory alteration parameters and the outcome (hospitalization and mortality) in COVID-19 patients. The mean platelet values (×109/L) differed between patients with positive or negative SARS-CoV-2 swabs (242.1 ± 92.1 in SARS-CoV-2 negative vs. 215.2 ± 82.8 in COVID-19 patients, p < 0.001). In COVID-19 patients, the platelet count correlated with the A-aO2 gradient (p = 0.001, rho = −0.149), with its increase over the expected (p = 0.013; rho = −0.115), with the PaO2 values (p = 0.036; rho = 0.093), with the PCO2 values (p = 0.003; rho = 0.134) and with the pH values (p = 0.016; rho = −0.108). In COVID-19 negative patients, the platelet values correlated only with the A-aO2 gradient: (p = 0.028; rho = −0.101). Patients discharged from emergency department had a mean platelet value of 234.3 ± 68.7, those hospitalized in ordinary wards had a mean value of 204.3 ± 82.5 and in patients admitted to sub-intensive/intensive care, the mean value was 201.7 ± 75.1. In COVID-19 patients, the survivors had an average platelet value at entry to the emergency department of 220.1 ± 81.4, while that of those who died was 206.4 ± 87.7. Our data confirm that SARS-CoV-2 infection may induce thrombocytopenia, and that the reduction in platelet counts could be correlated with the main blood gas parameters and with clinical outcome; as a consequence, platelet count could be an important prognostic factor to evaluate and stratify COVID-19 patients.

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“…Among factors not selected in Table 4, several are related to platelet: PLT itself, and MPV and PDW related to platelet size. Because platelet is a key regulator of thrombosis and inflammation, both present in severe COVID-19 patients, it is a good candidate for risk factor (Barrett et al, 2021; Rohlfing et al, 2021; Delshad et al, 2021). However, it is suggested that platelet/large-cell-cell ratio (PLCR) (Daniels et al, 2021) is a better marker than MPV and PDW, and platelet-to-lymphocyte ratio (PLR) (Asan et al, 2021) is a better marker than platelet count.…”

Section: Discussionmentioning

confidence: 99%

A Composite Ranking of Risk Factors for COVID-19 Time-To-Event Data from a Turkish Cohort

Ülgen

Çetin

et al. 2022

Preprint

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Having a complete and reliable list of risk factors from routine laboratory blood test for COVID-19 disease severity and mortality is important for patient care and hospital management. It is common to use meta-analysis to combine analysis results from different studies to make it more reproducible. In this paper, we propose to run multiple analyses on the same set of data to produce a more robust list of risk factors. With our time-to-event survival data, the standard survival analysis were extended in three directions. The first is to extend from tests and corresponding p-values to machine learning and their prediction performance. The second is to extend from single-variable to multiple-variable analysis. The third is to expand from analyzing time-to-decease data with death as the event of interest to analyzing time-to-hospital-release data to treat early recover as a meaningful event as well. Our extension of the type of analyses leads to ten ranking lists. We conclude that 20 out of 30 factors are deemed to be reliably associated to faster-death or faster-recovery. Considering correlation among factors and evidenced by stepwise variable selection in random survival forest, 10~15 factors seem to be able to achieve the optimal prognosis performance. Our final list of risk factors contains calcium, white blood cell and neutrophils count, urea and creatine, d-dimer, red cell distribution widths, age, ferritin, glucose, lactate dehydrogenase, lymphocyte, basophils, anemia related factors (hemoglobin, hematocrit, mean corpuscular hemoglobin concentration), sodium, potassium, eosinophils, and aspartate aminotransferase.

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Platelets in the perspective of COVID-19; pathophysiology of thrombocytopenia and its implication as prognostic and therapeutic opportunity

Abstract: Graphical abstract

Cited by 37 publications

References 153 publications

Baseline Thrombocytopenia and Disease Severity Among COVID-19 Patients, Tibebe Ghion Specialized Hospital COVID-19 Treatment Center, Northwest Ethiopia

Baseline Thrombocytopenia and Disease Severity Among COVID-19 Patients, Tibebe Ghion Specialized Hospital COVID-19 Treatment Center, Northwest Ethiopia

Platelet Count in Patients with SARS-CoV-2 Infection: A Prognostic Factor in COVID-19

A Composite Ranking of Risk Factors for COVID-19 Time-To-Event Data from a Turkish Cohort

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