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1.
Am J Emerg Med ; 51: 257-261, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1509482

ABSTRACT

OBJECTIVES: This study investigated the relationship between 28-day mortality in patients with COVID-19 pneumonia and the CURB-65 score, platelet count (PLT), mean platelet volume (MPV), and MPV/PLT ratio (MPR). METHODS: A total of 247 patients with COVID-19 pneumonia who presented to the emergency department between March 15, 2020 and May 15, 2020 were retrospectively analyzed. The age, gender, clinical presentation, history of chronic disease, thoracic computed tomography findings, MPV, PLT, MPR, CURB-65 scores, and 28-day mortality of patients were recorded. RESULTS: The patients had a mean age of 51 years (IQR: 39-63 years) and 55.5% were females. The most common symptom was cough (30.4% of patients). The most common comorbidity was hypertension (13.4%), 49.8% of the cases showed intermediate involvement, and 7.7% of patients died within the first 28 days. The mean MPV was 9.71 ± 1.15, the mean PLT was 226.68 ± 83.82, and the mean MPR was 0.056 ± 0.12. There were significant correlations of 28-day mortality with the CURB-65 score, MPV, and MPR levels (p = 0.000, p = 0.034, and p = 0.034, respectively). No significant correlation was found between the PLT count and 28-day mortality (p = 0.105). CONCLUSIONS: In addition to the CURB-65 score, MPV and MPR values can be used to predict 28-day mortality in patients with COVID-19 pneumonia.


Subject(s)
COVID-19/diagnosis , Platelet Count , Adult , COVID-19/blood , COVID-19/mortality , Comorbidity , Cough , Emergency Service, Hospital , Female , Humans , Hypertension , Logistic Models , Male , Mean Platelet Volume , Middle Aged , Prognosis , Retrospective Studies , Turkey
2.
Clin Appl Thromb Hemost ; 27: 10760296211048808, 2021.
Article in English | MEDLINE | ID: covidwho-1495924

ABSTRACT

We aimed to investigate association between mean platelet volume (MVP), platelet distribution width (PDW) and red cell distribution width (RDW) and mortality in patients with COVID-19 and find out in which patients the use of acetylsalicylic acid (ASA) affects the prognosis due to the effect of MPV on thromboxan A2. A total of 5142 patients were divided into those followed in the intensive care unit (ICU) and those followed in the ward. Patient medical records were examined retrospectively. ROC analysis showed that the area under curve (AUC) values were 0.714, 0.750, 0.843 for MPV, RDW and D-Dimer, the cutoff value was 10.45fl, 43.65fl, 500.2 ng/mL respectively. (all P < .001). Survival analysis showed that patients with MPV >10.45 f/l and D-Dimer >500.2 ng/mL, treatment with ASA had lower in-hospital and 180-day mortality than patients without ASA in ICU patients (HR = 0.773; 95% CI = 0.595-0.992; P = .048, HR = 0.763; 95% CI = 0.590-0.987; P = .036). Administration of low-dose ASA in addition to anti-coagulant according to MPV and D-dimer levels reduces mortality.


Subject(s)
Blood Platelets , COVID-19/blood , Erythrocyte Indices , Erythrocytes , Mean Platelet Volume , Aged , Aged, 80 and over , Anticoagulants/therapeutic use , Aspirin/therapeutic use , Blood Platelets/drug effects , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19/mortality , Female , Hospital Mortality , Humans , Male , Middle Aged , Platelet Aggregation Inhibitors/therapeutic use , Predictive Value of Tests , Retrospective Studies , Severity of Illness Index , Time Factors , Treatment Outcome
4.
Rev Bras Ginecol Obstet ; 43(8): 595-599, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1428974

ABSTRACT

OBJECTIVE: To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women. METHODS: A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation. RESULTS: Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87 ± 66.92 fL for the case group versus 9.84 ± 1.2 fL for the control group; PDW: 14.82 ± 3.18 fL for the case group versus 13.3 ± 2.16 fL for the controls). The criterion value of the receiver operating characteristic (ROC) curve for PDW at a cutoff point of > 11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of > 10.17 fL showed a good diagnostic marker. CONCLUSION: The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.


OBJETIVO: Descrever as alterações hematológicas, em particular os índices plaquetários em gestantes com doença coronavírus 2019 (COVID-19) em comparação com gestantes saudáveis. MéTODOS: Estudo caso-controle retrospectivo realizado no Hospital Universitário Al Yarmouk, em Bagdá, Iraque envolvendo 100 gestantes, 50 com DNA viral positivo para COVID-19 (grupo caso) e 50 com resultados negativos (grupo controle); ambos os grupos foram submetidos a uma avaliação hematológica completa. RESULTADOS: Entre as principais variáveis hematológicas analisadas, os índices plaquetários, nomeadamente o volume plaquetário médio (VPM) e a largura de distribuição plaquetária (PDW), apresentaram diferenças estatisticamente significativas (VPM: 10,87 ± 66,92 fL para o grupo caso versus 9,84 ± 1.2 fL para o o grupo controle; PDW: 14,82 ± 3,18 fL para o grupo caso versus 13,3 ± 2,16 fL para os controles). O valor de critério da curva de característica de operação do receptor (ROC) para PDW em um ponto de corte de> 11,8 fL mostrou um marcador diagnóstico fraco, enquanto o do VPM em um valor de corte de> 10,17 fL mostrou um bom marcador de diagnóstico. CONCLUSãO: O MPV e PDW são significativamente afetados por esta infecção viral, mesmo em casos confirmados assintomáticos, e recomendamos que ambos os parâmetros sejam incluídos no painel de diagnóstico desta infecção.


Subject(s)
Blood Platelets/virology , COVID-19/blood , Pregnancy Complications, Infectious/blood , Adult , Asymptomatic Diseases , Biomarkers/blood , Blood Platelets/physiology , COVID-19/diagnosis , COVID-19 Testing , Case-Control Studies , Female , Humans , Mean Platelet Volume , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Retrospective Studies
5.
Int J Lab Hematol ; 43(6): 1319-1324, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1416363

ABSTRACT

INTRODUCTION: Health professions are heavily engaged facing the current threat of SARS-CoV-2 (COVID-19). Although there are many diagnostic tools, an accurate and rapid laboratory procedure for diagnosing COVID-19 is recommended. We focused on platelet parameters as the additional biomarkers for clinical diagnosis in patients presenting to the emergency department (ED). MATERIALS AND METHODS: Five hundred and sixty-one patients from February to April 2020 have been recruited. Patients were divided into three groups: (N = 50) COVID-19 positive and (N = 21) COVID-19 negative with molecular testing, (N = 490) as reference population without molecular testing. A Multiplex rRT-PCR from samples collected by nasopharyngeal swabs was performed and the hematological data collected. RESULTS: We detected a mild anemia in COVID-19 group and lymphopenia against reference population: hemoglobin (g/dL) 13.0 (11.5-14.8) versus 13.9 (12.8-15.0) (P = .0135); lymphocytes (109 /L) 1.24 (0.94-1.73) versus 1.99 (1.49-2.64) (P < .0001). In addition, abnormal platelet parameters as follows (COVID group vs reference population): PLT (×109 /L) 209 (160-258) vs 236 (193-279) (P = .0239). IPF (%) 4.05 (2.5-5.9) versus 3.4 (2.2-4.9) (P = .0576); H-IPF (%) 1.25 (0.8-2.2) versus 0.95 (0.6-1.5) (P = .0171) were identified. In particular, COVID positive group had a high H-IPF/IPF Ratio compared to reference population [0.32 (0.29-0.36) versus 0.29 (0.26-0.32), respectively, (P = .0003)]. Finally, a PLT difference of nearly 50 × 109 /L between pre/postCOVID-19 sampling for each patient was found (N = 42) (P = .0194). CONCLUSIONS: COVID-19 group results highlighted higher IPF and H-IPF values, with increased H-IPF/IPF Ratio, associated to PLT count reduction. These findings shall be adopted for a timely diagnosis of patients upon hospital admission.


Subject(s)
COVID-19 Testing/methods , COVID-19/blood , Pandemics , Platelet Count , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , Anemia/etiology , Blood Cell Count , Blood Platelets/pathology , COVID-19/diagnosis , Cell Differentiation , Cell Size , Disease Progression , Emergency Service, Hospital , Female , Hemoglobins/analysis , Humans , Italy/epidemiology , Male , Mean Platelet Volume , Middle Aged , Multiplex Polymerase Chain Reaction , Nasopharynx/virology , Pilot Projects , Retrospective Studies , SARS-CoV-2/isolation & purification
8.
Acta Clin Croat ; 60(1): 103-114, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1332468

ABSTRACT

Coronavirus was first detected in three severe pneumonia cases in Wuhan, China, in December 2019. Studies on red cell distribution width (RDW-CV) and mean platelet volume (MPV) laboratory parameters, which can be examined in complete blood count in COVID-19 patients, are still very limited. However, to the best of our knowledge, there are no studies examining the relationship between platelet volume index (PVI) and disease severity in COVID-19 patients, which was evaluated in this study. The aim of this study was to evaluate the relationship of disease severity in COVID-19 patients with their MPV, RDW, and PVI parameters. The study included 92 COVID-19 patients as a study group and 84 healthy individuals as control group. All laboratory data and radiological images were scanned retrospectively from patient files and hospital information system. Evaluation of the RDW-CV and MPV blood parameters, and PVI measured in COVID-19 patients yielded statistically significant differences according to the disease severity. We suggest that RDW-CV and PVI, evaluated within the scope of the study, may be the parameters that should be considered in the early diagnosis of the disease, from the initial stages of COVID-19. In addition, we think that the RDW-CV and MPV laboratory parameters, as well as PVI, which all are simple, inexpensive and widely used hematologic tests, can be used as important biomarkers in determining COVID-19 severity and mortality.


Subject(s)
COVID-19 , Mean Platelet Volume , Erythrocyte Indices , Humans , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(7): 890-895, 2021 Jul 06.
Article in Chinese | MEDLINE | ID: covidwho-1323327

ABSTRACT

To provide new ideas for clinical diagnosis and treatment of coronavirus disease 2019 (COVID-19), this study explore the expression level and prognostic value of platelet parameters in mild, moderate and severe COVID-19. This is a retrospective analysis. From January to May 2020, a total of 69 patients who were diagnosed with COVID-19 in the Third Central Hospital and the Jinnan Hospital (both situated in Tianjin) were enrolled in the disease group. According to the severity, these patients were divided into mild group (15 cases), moderate group (46 cases), and severe group (8 cases). In the same period, 70 non-infected patients were enrolled in control group. The level of white blood cell count (WBC), absolute neutrophil count (NEU#), absolute lymphocyte count (LY#), neutrophil-lymphocyte ratio (NLR), red blood cell count (RBC), hemoglobin (Hb), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large contrast ratio (P-LCR) before and after treatment were analyzed. Binary logistic regression analysis is used to establish a mathematical model of the relationship between these indexes and the outcome of severe COVID-19 patients. The receiver operating characteristic(ROC) curve is used to further explore the prognosis value of MPV, P-LCR, NLR separately and jointly in COVID-19 patients. Compare to the control group, WBC and NE# increase (Z=-5.63, P<0.01;Z=-9.19,P<0.01) and LY# decrease (Z=-9.34, P<0.01) in the severe group; NLR increase with the aggravation of the disease, there is significant difference between groups (Z=17.61, P<0.01); PLT, PDW, MPV and P-LCR decrease with the aggravation of the disease, there is significant difference between groups (Z=9.47, P<0.01; Z=11.41, P<0.01; Z =16.76, P<0.01; Z=13.97, P<0.01). Binary logistic regression analysis shows MPV, P-LCR and NLR have predictive value for severe COVID-19 patients. There is a negative correlation between MPV, P-LCR and severe COVID-19 patients (OR=1.004, P=0.034; OR=1.097, P=0.046). There is a positive correlation between NLR and severe COVID-19 patients (OR=1.052, P=0.016). MPV and P-LCR of patients with good prognosis after treatment were significantly higher than those before treatment (Z=-6.47, P<0.01; Z=-5.36, P<0.01). NLR was significantly lower than that before treatment (Z=-8.13, P<0.01). MPV and P-LCR in poor prognosis group were significantly lower than those before treatment (Z=-9.46, P<0.01; Z=-6.81, P<0.01). NLR was significantly higher than that before treatment (Z=-3.24, P<0.01). There were significant differences between good and poor prognosis groups before and after treatment in MPV, P-LCR and NLR (P<0.01). Combination of these three indexes, ROC shows the AUC is 0.931, the sensitivity is 91.5%, the specificity is 94.1%, the positive predictive value is 88.9%, and the negative predictive value is 87.4%, which is better than any of these indexes separately. Changes in these parameters are closely related to clinical stage of COVID-19 patients. MPV, P-LCR and NLR are of great value in the prediction and prognosis of severe COVID-19 patients.


Subject(s)
COVID-19 , Mean Platelet Volume , Humans , Lymphocytes , Neutrophils , ROC Curve , Retrospective Studies , SARS-CoV-2
10.
Clin Lab ; 67(7)2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1310231

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has affected the health system around the world. It is necessary to facilitate health care services with useful parameters in patient follow-up. In this study, we wanted to determine whether platelet indices can be used as an assistant parameter in the clinician's decision-making process regarding which of the patients diagnosed with COVID-19 should be treated by hospitalization. METHODS: This retrospective study was performed in a secondary care hospital in Mugla, Turkey. Demographic information such as age, gender, and comorbidities of patients admitted to the emergency pandemic outpatient clinic within five months and diagnosed with COVID-19, as well as discharge, hospitalization, or intensive care needs (ICU), and thirty-day mortality were noted. Also, patients with platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), thrombocytocrit (PCT), MPV/PLT, MPV/PCT, PDW/PLT, PDW/PCT values for outpatient follow-up, hospitalization, intensive care unit need, and 30-day mortality relationships were examined. RESULTS: A total of 93 patients diagnosed with COVID-19 were included in the study. It was observed that those with comorbidity had a statistically significant higher rate of hospitalization (p = 0.013). No statistically significant difference was found between outpatients and inpatients in terms of PLT, MPV, PDW, PCT, MPV/PLT, MPV/ PCT, PDW/PLT, and PDW/PCT (p > 0.05 for each). CONCLUSIONS: Platelet indices such as PLT, MPV, PDW, PCT, MPV/PLT, MPV/PCT, PDW/PLT, and PDW/PCT are not useful parameters for the clinician to distinguish between outpatient and inpatient treatment of patients with COVID-19.


Subject(s)
COVID-19 , Outpatients , Blood Platelets , Humans , Infant , Mean Platelet Volume , Retrospective Studies , SARS-CoV-2 , Turkey
11.
Bratisl Lek Listy ; 122(6): 413-417, 2021.
Article in English | MEDLINE | ID: covidwho-1232644

ABSTRACT

OBJECTIVES: This study aims to determine the prognostic significance of the lymphocyte/mean platelet volume ratio (LMR) in terms of the clinical course of the disease in patients with COVID-19. METHODS: Patients over 18 who were evaluated for COVID-19 during the period from April 1, to April 30, 2020 were retrospectively scanned. Patients with at least 1 positive PCR test result were as assigned to Group 1 while patients with negative test results were assigned to Group 2. The LMR ratio was calculated by dividing the lymphocyte value by that of MPV. The relationship between LMR, severity of patients' CT findings and 28-day mortality was evaluated. RESULTS: A total of 938 patients were included in the study. It was observed that the lymphocyte and LMR levels were significantly different in those who died within 28 days (p < 0.001, p ≤ 0.001). In the ROC analysis for the LMR level, the area under the curve (AUC) was found to be 0.737 (95% CI 0.639‒0.834). When the cut­off value of LMR was 0.045, the sensitivity was found to be 99.0 % and specificity was 15.2 %. CONCLUSION: LMR can be a guide in multiple cases of care provided to critical patients, as is the case in the COVID-19 pandemic and can be used in recognizing critical patients (Tab. 5, Fig. 1, Ref. 21).


Subject(s)
COVID-19 , Mean Platelet Volume , Humans , Lymphocytes , Monocytes , Pandemics , Prognosis , ROC Curve , Retrospective Studies , SARS-CoV-2
12.
Prim Care Diabetes ; 15(4): 713-718, 2021 08.
Article in English | MEDLINE | ID: covidwho-1225362

ABSTRACT

AIM: This study aimed at providing evidence to consider sex differences in interpretations of laboratory parameters of severe COVID-19 patients with diabetes. METHODS: For 118 diabetic patients, laboratory measurements and clinical outcomes were compared between males and females. This study also compared inflammatory ratios obtained from combinations of six inflammatory markers between the two groups. The risk factors for mortality were identified through logistic regression. RESULTS: Males were 54 (45.8%) and females were 64 (54.2%). Males showed a significant increase in ALT (P = 0.003), CRP (P = 0.03), mean platelet volume (MPV)-to-lymphocyte ratio (P = 0.001), and C-reactive protein-to-albumin ratio (P = 0.044), whereas females had a significant increase in lymphocytes (P < 0.005) and MPV (P = 0.01). In all participants, multivariate analysis illustrated that older age, male sex, increased serum total bilirubin, and decreased PO2 were significant independent predictors of mortality (P < 0.05). CONCLUSION: In severe COVID-19 patients with diabetes, there were significant sex differences in many laboratory characteristics with a higher risk of mortality among males.


Subject(s)
Biomarkers/blood , COVID-19/diagnosis , Diabetes Mellitus/diagnosis , Health Status Disparities , Age Factors , Aged , Alanine Transaminase/blood , Bilirubin/blood , C-Reactive Protein/analysis , COVID-19/blood , COVID-19/mortality , Diabetes Mellitus/blood , Diabetes Mellitus/mortality , Female , Humans , Lymphocyte Count , Lymphocytes/metabolism , Male , Mean Platelet Volume , Middle Aged , Predictive Value of Tests , Prognosis , Retrospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , Sex Factors
14.
J Med Virol ; 93(5): 3227-3237, 2021 May.
Article in English | MEDLINE | ID: covidwho-1196543

ABSTRACT

There have been a limited number of studies on coronavirus disease 2019 (COVID-19) in children. In this study, we aimed to investigate the demographic, clinical, and laboratory features of COVID-19 and to identify the role of mean platelet volume (MPV) in predicting the prognosis in children. A single-center retrospective study, including 251 confirmed and 65 suspected COVID-19 cases, was conducted between March 11, 2020, and December 11, 2020. In the confirmed COVID-19 group, 48 (19.1%) patients were asymptomatic, 183 (72.9%) mild, 16 (6.4%) moderate, 1 (0.4%) severe, and 3 were (1.2%) critically ill. Confirmed COVID-19 patients had significantly lower mean values of white blood cell (WBC), absolute neutrophil count, absolute lymphocyte count, platelet, and hemoglobin (p < .001). However, there was no significant difference in MPV levels between the two groups (p = .894). C-reactive protein (CRP), procalcitonin, fibrinogen, and NT-pro-BNP mean values were significantly lower in confirmed COVID-19 cases than suspected cases (p < .001). A total of 55 (21.9%) patients required hospitalization due to COVID-19, and MPV, WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP were statistically higher in hospitalized patients than those in outpatients. The multivariate analysis of confirmed COVID-19 cases according to the severity of disease showed that lymphopenia and higher levels of fibrinogen significantly associated with severe clinical symptoms. Decision tree analysis showed that the most powerful predictor of hospitalization due to COVID-19 was the D-dimer (p < .001). MPV values are not associated with COVID-19 disease severity. However, MPV can be used with other parameters such as WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP to predict hospitalization.


Subject(s)
COVID-19/pathology , Mean Platelet Volume , SARS-CoV-2 , Adolescent , COVID-19/blood , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Male , Prognosis , Retrospective Studies , Risk Factors , Sensitivity and Specificity , Severity of Illness Index
15.
Expert Rev Endocrinol Metab ; 16(3): 147-153, 2021 05.
Article in English | MEDLINE | ID: covidwho-1165207

ABSTRACT

Objectives: Changes in hematological parameters are becoming evident as important early markers of COVID-19. Type 2 Diabetes Mellitus (T2DM) has been shown to be associated with increased severity of COVID-19. In this study, we aim to explore the various hematological variables in COVID-19 positive patients with T2DM, so as to act early and improve patient outcomes.Methods: Medical e-records of seventy adult patients with T2DM who were COVID-19 positive have been analyzed in this retrospective cohort study. Demographic, clinical and laboratory parameters for these patients were examined.Results: Of the seventy patients with T2DM, 48.88% had poorly controlled diabetes. 70.69% were pyrexial, 56.25% were tachycardic and 38.58% were asymptomatic on presentation. Amongst the hematological parameters, anemia was seen in 10% of males and 15.38% of females. 20% had a high red-blood-cell-distribution-width (RDW). 7.27% had thrombocytosis and 3.64% had thrombocytopenia. 73.3% had a high platelet-distribution-width (PDW) and 44.44% had an increased mean-platelet-volume (MPV). 16.36% were neutropenic and 16.67% had lymphocytopenia.Conclusion: Diabetic COVID-19 positive patients have been shown to have prominent manifestations of the hemopoietic-system with varied hematological profiles. Recognizing the implications of these variables early in primary-care, can help clinicians aid management decisions and dictate early referral to secondary-care services, to help improve prognosis.


Subject(s)
COVID-19/blood , Diabetes Mellitus, Type 2/blood , Hematologic Diseases/blood , Primary Health Care/trends , Adult , Anemia/blood , Anemia/diagnosis , Anemia/epidemiology , Biomarkers/blood , COVID-19/diagnosis , COVID-19/epidemiology , Cohort Studies , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Erythrocyte Indices/physiology , Female , Hematologic Diseases/diagnosis , Hematologic Diseases/epidemiology , Humans , Male , Mean Platelet Volume/methods , Mean Platelet Volume/trends , Middle Aged , Platelet Count/methods , Platelet Count/trends , Primary Health Care/methods , Retrospective Studies , Thrombocytopenia/blood , Thrombocytopenia/diagnosis , Thrombocytopenia/epidemiology
16.
J Clin Lab Anal ; 35(4): e23703, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1151916

ABSTRACT

COVID-19 has a worldwide distribution; however, there is no effective diagnosis marker, especially for the mild-type COVID-19. The purpose of the current study was to identify parameters for mild-type COVID-19. We retrospectively analyzed a single-center data of patients with mild COVID-19. Forty patients diagnosed with COVID-19 were enrolled. Peripheral blood indices between the admission and discharge times were collected and analyzed. The platelet distribution width (PDW) was shown to be an indicator of significant change. The receiver operating characteristic curve for PDW was 0.7; the sensitivity and specificity for PDW were 82.5% and 55.0%, respectively. Therefore, a potential diagnostic value of PDW for mild-type COVID-19 was demonstrated.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Mean Platelet Volume/methods , Adult , Aged , COVID-19/blood , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , ROC Curve , Retrospective Studies
17.
J Med Virol ; 93(5): 3227-3237, 2021 May.
Article in English | MEDLINE | ID: covidwho-1100915

ABSTRACT

There have been a limited number of studies on coronavirus disease 2019 (COVID-19) in children. In this study, we aimed to investigate the demographic, clinical, and laboratory features of COVID-19 and to identify the role of mean platelet volume (MPV) in predicting the prognosis in children. A single-center retrospective study, including 251 confirmed and 65 suspected COVID-19 cases, was conducted between March 11, 2020, and December 11, 2020. In the confirmed COVID-19 group, 48 (19.1%) patients were asymptomatic, 183 (72.9%) mild, 16 (6.4%) moderate, 1 (0.4%) severe, and 3 were (1.2%) critically ill. Confirmed COVID-19 patients had significantly lower mean values of white blood cell (WBC), absolute neutrophil count, absolute lymphocyte count, platelet, and hemoglobin (p < .001). However, there was no significant difference in MPV levels between the two groups (p = .894). C-reactive protein (CRP), procalcitonin, fibrinogen, and NT-pro-BNP mean values were significantly lower in confirmed COVID-19 cases than suspected cases (p < .001). A total of 55 (21.9%) patients required hospitalization due to COVID-19, and MPV, WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP were statistically higher in hospitalized patients than those in outpatients. The multivariate analysis of confirmed COVID-19 cases according to the severity of disease showed that lymphopenia and higher levels of fibrinogen significantly associated with severe clinical symptoms. Decision tree analysis showed that the most powerful predictor of hospitalization due to COVID-19 was the D-dimer (p < .001). MPV values are not associated with COVID-19 disease severity. However, MPV can be used with other parameters such as WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP to predict hospitalization.


Subject(s)
COVID-19/pathology , Mean Platelet Volume , SARS-CoV-2 , Adolescent , COVID-19/blood , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Male , Prognosis , Retrospective Studies , Risk Factors , Sensitivity and Specificity , Severity of Illness Index
18.
PLoS Biol ; 19(2): e3001109, 2021 02.
Article in English | MEDLINE | ID: covidwho-1088651

ABSTRACT

Coronavirus Disease 2019 (COVID-19), caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has affected over 30 million globally to date. Although high rates of venous thromboembolism and evidence of COVID-19-induced endothelial dysfunction have been reported, the precise aetiology of the increased thrombotic risk associated with COVID-19 infection remains to be fully elucidated. Therefore, we assessed clinical platelet parameters and circulating platelet activity in patients with severe and nonsevere COVID-19. An assessment of clinical blood parameters in patients with severe COVID-19 disease (requiring intensive care), patients with nonsevere disease (not requiring intensive care), general medical in-patients without COVID-19, and healthy donors was undertaken. Platelet function and activity were also assessed by secretion and specific marker analysis. We demonstrated that routine clinical blood parameters including increased mean platelet volume (MPV) and decreased platelet:neutrophil ratio are associated with disease severity in COVID-19 upon hospitalisation and intensive care unit (ICU) admission. Strikingly, agonist-induced ADP release was 30- to 90-fold higher in COVID-19 patients compared with hospitalised controls and circulating levels of platelet factor 4 (PF4), soluble P-selectin (sP-selectin), and thrombopoietin (TPO) were also significantly elevated in COVID-19. This study shows that distinct differences exist in routine full blood count and other clinical laboratory parameters between patients with severe and nonsevere COVID-19. Moreover, we have determined all COVID-19 patients possess hyperactive circulating platelets. These data suggest abnormal platelet reactivity may contribute to hypercoagulability in COVID-19 and confirms the role that platelets/clotting has in determining the severity of the disease and the complexity of the recovery path.


Subject(s)
Blood Platelets/virology , COVID-19/blood , Adenosine Triphosphate/metabolism , Aged , Blood Coagulation , Blood Platelets/cytology , Enzyme-Linked Immunosorbent Assay , Female , Hemostasis , Humans , Inflammation , Intensive Care Units , Male , Mean Platelet Volume , Middle Aged , P-Selectin/blood , Phenotype , Platelet Factor 4/blood , Platelet Function Tests , Thrombopoietin/blood
19.
Platelets ; 32(1): 130-137, 2021 Jan 02.
Article in English | MEDLINE | ID: covidwho-1066099

ABSTRACT

The coronavirus disease 19 (COVID-19) is a highly transmittable viral infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 utilizes metallocarboxyl peptidase angiotensin receptor (ACE) 2 to gain entry into human cells. Activation of several proteases facilitates the interaction of viral spike proteins (S1) and ACE2 receptor. This leads to cleavage of host ACE2 receptors. ACE2 activity counterbalances the angiotensin II effect, its loss may lead to elevated angiotensin II levels with modulation of platelet function, size and activity. COVID-19 disease encompasses a spectrum of systemic involvement far beyond respiratory failure alone. Several features of this disease, including the etiology of acute kidney injury (AKI) and the hypercoagulable state, remain poorly understood. Here, we show that there is a high incidence of AKI (81%) in the critically ill adults with COVID-19 in the setting of elevated D-dimer, elevated ferritin, C reactive protein (CRP) and lactate dehydrogenase (LDH) levels. Strikingly, there were unique features of platelets in these patients, including larger, more granular platelets and a higher mean platelet volume (MPV). There was a significant correlation between measured D-dimer levels and MVP; but a negative correlation between MPV and glomerular filtration rates (GFR) in critically ill cohort. Our data suggest that activated platelets may play a role in renal failure and possibly hypercoagulability status in COVID19 patients.


Subject(s)
Acute Kidney Injury/etiology , Angiotensin II/metabolism , Angiotensin-Converting Enzyme 2/metabolism , Blood Platelets/pathology , COVID-19/complications , Pandemics , Receptors, Virus/metabolism , SARS-CoV-2 , Thrombocytopenia/etiology , Thrombophilia/etiology , Acute Kidney Injury/blood , Acute Kidney Injury/physiopathology , Adult , Aged , Aged, 80 and over , COVID-19/blood , COVID-19/epidemiology , Comorbidity , Diabetes Mellitus/epidemiology , Female , Fibrin Fibrinogen Degradation Products/analysis , Glomerular Filtration Rate , Humans , Hypertension/epidemiology , Male , Mean Platelet Volume , Middle Aged , Renin-Angiotensin System/physiology , Thrombophilia/blood , Young Adult
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