Predicting acute respiratory distress syndrome in influenza pneumonia patients using delta mean platelet volume

Abstract

Background Patients with influenza pneumonia are at high risk of rapid progression to acute respiratory distress syndrome (ARDS). Mean platelet volume (MPV), which reflects platelet size, is considered to be a crucial inflammatory marker. The study aim was to investigate the role of delta mean platelet volume (delta MPV) in predicting ARDS in patients with influenza pneumonia. Methods This retrospective study was conducted in a tertiary care centre in southern Thailand. Adult patients diagnosed with influenza pneumonia were enrolled from January 2015 to December 2020. Demographic data, laboratory investigations including delta MPV (MPV on day 2 minus MPV on day 1), management records, and clinical outcomes were collected for analysis. The study population was divided into two groups according to the development of ARDS. Results During the study, 1240 patients with laboratory-confirmed influenza were screened and 212 pneumonia patients were enrolled. Fifty-six patients (26.4%) met the diagnostic criteria for ARDS during hospitalization. Delta MPV was significantly higher in the ARDS group compared to that in the non-ARDS group (1.0 fL vs 0.2 fL, p < 0.001). Multivariable logistic regression revealed that delta MPV is an independent predictor of ARDS (OR 17.37; 95% CI 6.5–46.4; p < 0.001). Receiver operating characteristic curve analysis indicated a cut-off value of 0.7 fL for delta MPV (sensitivity 80.36%, specificity 80.77%) to predict ARDS in patients with influenza pneumonia. Conclusions Delta MPV strongly predicts ARDS in influenza pneumonia patients. Implementation of delta MPV may be useful in identifying at-risk patients who will require intensive care and ARDS prevention.

Clinical profile of children with influenza like illness during pre-monsoon at coastal Karaikal, Puducherry, India

“…But influenza B was not included in the study population. It also demonstrated high white cell count, thrombocytosis, low mean platelet volume in lower respiratory tract infections by adeno virus in the same category [ 17 ] Serial increase in mean platelet volume (δ) estimation was used to predict the progression to pneumonia in children and ARDS in adults during Influenza pandemics in Thailand study by Teeraphat et al [ 18 ]. It has been identified that platelets engulf viral particles of Influenza which bind to platelet sialoglycans resulting in the removal of sialic acid by viral neuraminidase.…”

Mean platelet volume is useful for predicting weaning failure: a retrospective, observational study

“…Among sepsis patients, an increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock [ 8 ]. Among influenza pneumonia patients, the change of MVP strongly predicts acute respiratory distress syndrome [ 9 ]. It was also reported that higher MPV was an independent risk factors for the poor prognosis of patients with acute pulmonary embolism [ 10 ].…”

Mean platelet volume as a predictive biomarker for in-hospital mortality in patients receiving invasive mechanical ventilation

“…Mean platelet volume (MPV), a routinely measured marker in clinical practice, is a simple, easy, available, and accurate indicator of platelet size and function [ 11 ]. Numerous studies have demonstrated that MPV levels or the change of MPV were correlated with serious compilation or poor prognosis for ICU patients [ 12 , 13 ], sepsis [ 14 , 15 ], influenza pneumonia [ 16 ], acute pulmonary embolism [ 17 ].In addition, MPV also has been shown to be a valuable prognostic marker for patients following acute abdominal surgery [ 18 ], chronic obstructive pulmonary disease (COPD) patients [ 19 ], coronary artery disease [ 20 ] and Type 2 Diabetes Mellitus [ 21 ].…”