Thrombocytopenia and its association with mortality in patients with COVID‐19

Abstract

Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which causes novel coronavirus disease 2019 (COVID‐19), is spreading rapidly around the world. Thrombocytopenia in patients with COVID‐19 has not been fully studied. Objective To describe thrombocytopenia in patients with COVID‐19. Methods For each of 1476 consecutive patients with COVID‐19 from Jinyintan Hospital, Wuhan, China, nadir platelet count during hospitalization was retrospectively collected and categorized into (0, 50], (50, 100], (100‐150], or (150‐) groups after taking the unit (×109/L) away from the report of nadir platelet count. Nadir platelet counts and in‐hospital mortality were analyzed. Results Among all patients, 238 (16.1%) patients were deceased and 306 (20.7%) had thrombocytopenia. Compared with survivors, non‐survivors were older, were more likely to have thrombocytopenia, and had lower nadir platelet counts. The in‐hospital mortality was 92.1%, 61.2%, 17.5%, and 4.7% for (0, 50], (50, 100], (100‐150], and (150‐) groups, respectively. With (150‐) as the reference, nadir platelet counts of (100‐150], (50, 100], and (0, 50] groups had a relative risk of 3.42 (95% confidence interval [CI] 2.36‐4.96), 9.99 (95% CI 7.16‐13.94), and 13.68 (95% CI 9.89‐18.92), respectively. Conclusions Thrombocytopenia is common in patients with COVID‐19, and it is associated with increased risk of in‐hospital mortality. The lower the platelet count, the higher the mortality becomes.

Practical guidance for the management of adults with immune thrombocytopenia during the COVID‐19 pandemic

“…Indeed, the lower the platelet count, the worse the prognosis. This was supported by a recent, large, single‐centre study from Wuhan involving 1,476 consecutive patients with COVID‐19, showing mortality increasing with progressively lower platelet counts 37 . This is perhaps not unexpected, as other studies of critically ill patents show thrombocytopenia to be a marker of poor clinical outcome 24 .…”

Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis

“…The search process identi ed 1832 publications in the initial search. After screening, we included 36 studies in the systematic review , of which 27 were included in the meta-analysis [3,5,6,9,[11][12][13]15,16,[19][20][21][22][23][24][25][26][28][29][30][31][32][33][34][35][36]38]. The literature selection process is shown in Figure 1.…”

What do monitoring platelet counts in COVID‐19 teach us?

“…Yang and colleagues published the relevance of thrombocytopenia in COVID-19 patients and its association with mortality in this condition in the Journal of Thrombosis and Haemostasis. 1 The authors are to be applauded for the largest so-far analysis in the epidemiology of thrombocytopenia in patients with COVID-19. In addition to the association with mortality, there may be several other findings in this interesting paper that deserve mention.…”