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Kevin Manuel https://orcid.org/0000-0002-2425-5097
Marie Moses Ambroise https://orcid.org/0000-0001-8098-4465
Anita Ramdas https://orcid.org/0000-0001-8202-0133
Renu G’Boy Varghese https://orcid.org/0000-0002-7562-397X
Natarajan Vasanthi https://orcid.org/0000-0003-4674-143X
Kandasamy Ravichandran https://orcid.org/0000-0003-4239-3597

Abstract

The majority of the published studies have described the alterations in platelet count and platelet indices in both severe and non-severe Coronavirus Disease 2019 (COVID-19). However, their association with COVID-19 mortality remains unclear. In the present study, our aim is to determine the temporal evolution of platelet count and its parameters between survivors and non-survivors, as well as their potential association with clinical outcomes. This cross-sectional study included 1118 inpatients (≥18 years old) diagnosed as SARS-CoV-2 positive by a Real-Time Polymerase Chain Reaction (RT-PCR) and hospitalized between May 1st, 2020 and November 1st, 2020. Data of complete
 blood count (CBC) parameters evaluated on different days after admission was gathered and the median value of each CBC parameter was considered for assessing the difference between survivors and non-survivors. There was statistically significant variation between survivors and non-survivors for platelet count [p<0.001, mean difference-80 x 109/L], mean platelet volume [p<0.001, mean difference- 0.7 fL], platelet distribution width [p<0.001, mean difference-2.5%] and platelet-lymphocyte ratio [p<0.001, mean difference-123.8]. Thrombocytopenia occurred more commonly in deceased patients compared to survivors. Platelet count, Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) differed significantly between survivors and non-survivors, revealing distinct trends indicating their importance in the management of COVID-19 patients. These cost-effective parameters can be easily obtained from a CBC.

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How to Cite
Manuel, K., Ambroise, M. M., Ramdas, A., Varghese, R. G., Vasanthi, N. and Ravichandran, K. (2024) “Clinical and diagnostic utility of platelet count and its parameters in COVID-19”, Indonesian Journal of Medical Laboratory Science and Technology, 6(1), pp. 18–26. doi: 10.33086/ijmlst.v6i1.5405.
Section
Articles
COVID-19, Fever, Thrombocytopenia, Platelet count

References

Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924. https://doi.org/10.1016/j.ijantimicag.2020.105924 DOI: https://doi.org/10.1016/j.ijantimicag.2020.105924

Andrews MA, Areekal B, Rajesh KR, Krishnan J, Suryakala R, Krishnan B, et al. First confirmed case of COVID-19 infection in India: A case report. Indian J Med Res. 2020;151(5):490-492. https://doi.org/10.4103/ijmr.IJMR_2131_20 DOI: https://doi.org/10.4103/ijmr.IJMR_2131_20

Letícia de Oliveira Toledo S, Sousa Nogueira L, das Graças Carvalho M, Romana Alves Rios D, de Barros Pinheiro M. COVID-19: Review and hematologic impact. Clin Chim Acta. 2020;510:170-176. https://doi.org/10.1016/j.cca.2020.07.016 DOI: https://doi.org/10.1016/j.cca.2020.07.016

Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–847. https://doi.org/10.1111/jth.14768 DOI: https://doi.org/10.1111/jth.14768

Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):4. https://doi.org/10.1186/s40779-020-0233-6 DOI: https://doi.org/10.1186/s40779-020-0233-6

Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58(7):1021-1028. https://doi.org/10.1515/cclm-2020-0369 DOI: https://doi.org/10.1515/cclm-2020-0369

Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, et al. Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study. Platelets. 2020;31(4):490-496. https://doi.org/10.1080/09537104.2020.1754383 DOI: https://doi.org/10.1080/09537104.2020.1754383

Wool GD, Miller JL. The Impact of COVID-19 Disease on Platelets and coagulation. pathobiology. 2021;88(1):15-27. https://doi.org/10.1159/000512007 DOI: https://doi.org/10.1159/000512007

Handtke S, Thiele T. Large and small platelets-(When) do they differ?. J Thromb Haemost. 2020;18(6):1256-1267. https://doi.org/10.1111/jth.14788 DOI: https://doi.org/10.1111/jth.14788

Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, Yaylacı S, at al. Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras (1992). 2020;66(8):1122-1127. https://doi.org/10.1590/1806-9282.66.8.1122 DOI: https://doi.org/10.1590/1806-9282.66.8.1122

Lanini S, Montaldo C, Nicastri E, Vairo F, Agrati C, Petrosillo N, et al. COVID-19 disease- Temporal analyses of complete blood count parameters over course of illness, and relationship to patient demographics and management outcomes in survivors and non- survivors: A longitudinal descriptive cohort study. PLoS One. 2020;15(12):e0244129. https://doi.org/10.1371/journal.pone.0244129 DOI: https://doi.org/10.1371/journal.pone.0244129

Shankaralingappa A, Tummidi S, Arun Babu T. Diagnostic value of platelet indices in COVID 19 infection: a case-control study from a single tertiary care center. Egypt J Intern Med. 2022;34(1):35. https://doi.org/10.1186/s43162-022-00123-x DOI: https://doi.org/10.1186/s43162-022-00123-x

Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochem Med (Zagreb). 2016;26(2):178-93. https://doi.org/10.11613/BM.2016.020 DOI: https://doi.org/10.11613/BM.2016.020

Pogorzelska K, Krętowska A, Krawczuk-Rybak M, Sawicka-Żukowska M. Characteristics of platelet indices and their prognostic significance in selected medical condition - a systematic review. Adv Med Sci. 2020;65(2):310-315. https://doi.org/10.1016/j.advms.2020.05.002 DOI: https://doi.org/10.1016/j.advms.2020.05.002

Barrett TJ, Lee AH, Xia Y, Lin LH, Black M, Cotzia P, et al. Platelet and vascular biomarkers associate with thrombosis and death in coronavirus disease. Circ Res. 2020;127(7):945-947. https://doi.org/10.1161/CIRCRESAHA.120.317803 DOI: https://doi.org/10.1161/CIRCRESAHA.120.317803

Ouyang SM, Zhu HQ, Xie YN, Zou ZS, Zuo HM, Rao YW, et al. Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19. BMC Infect Dis. 2020;20(1):952. https://doi.org/10.1186/s12879-020-05678-0 DOI: https://doi.org/10.1186/s12879-020-05678-0

Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost. 2020;18(6):1469-1472. https://doi.org/10.1111/jth.14848 DOI: https://doi.org/10.1111/jth.14848

Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-1026. https://doi.org/10.1111/jth.14810 DOI: https://doi.org/10.1111/jth.14810

Bommenahalli Gowda S, Gosavi S, Ananda Rao A, Shastry S, Raj SC, Menon S, et al. Prognosis of COVID-19: Red cell distribution width, platelet distribution width, and c-reactive protein. Cureus. 2021;13(2):e13078. https://doi.org/10.7759/cureus.13078 DOI: https://doi.org/10.7759/cureus.13078

Lim AYH, Goh JL, Chua MCW, Heng BH, Abisheganaden JA, George PP. Temporal changes of haematological and radiological findings of the COVID-19 infection-a review of literature. BMC Pulm Med. 2021;21(1):37. https://doi.org/10.1186/s12890-020-01389-z DOI: https://doi.org/10.1186/s12890-020-01389-z

Weyrich AS, Zimmerman GA. Platelets in lung biology. Annu Rev Physiol. 2013;75:569-591. https://doi.org/10.1146/annurev-physiol-030212-183752 DOI: https://doi.org/10.1146/annurev-physiol-030212-183752

Ciccullo A, Borghetti A, Zileri Dal Verme L, Tosoni A, Lombardi F, Garcovich M, et al. Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line. Int J Antimicrob Agents. 2020;56(2):106017. https://doi.org/10.1016/j.ijantimicag.2020.106017 DOI: https://doi.org/10.1016/j.ijantimicag.2020.106017

Chan AS, Rout A. Use of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19. J Clin Med Res. 2020;12(7):448-453. https://doi.org/10.14740/jocmr4240 DOI: https://doi.org/10.14740/jocmr4240

Li X, Liu C, Mao Z, Xiao M, Wang L, Qi S, et al. Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2020;24(1):647. https://doi.org/10.1186/s13054-020-03374-8 DOI: https://doi.org/10.1186/s13054-020-03374-8

Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, et al. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020;146(1):89-100. https://doi.org/10.1016/j.jaci.2020.05.003 DOI: https://doi.org/10.1016/j.jaci.2020.05.003

Chen L, Yu J, He W, Chen L, Yuan G, Dong F, et al. Risk factors for death in 1859 subjects with COVID-19. Leukemia. 2020;34(8):2173-2183. https://doi.org/10.1038/s41375-020-0911-0 DOI: https://doi.org/10.1038/s41375-020-0911-0

Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504. https://doi.org/10.1016/j.intimp.2020.106504 DOI: https://doi.org/10.1016/j.intimp.2020.106504

Wang X, Li X, Shang Y, Wang J, Zhang X, Su D, et al. Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre. Epidemiol Infect. 2020;148:e211. https://doi.org/10.1017/S0950268820002071 DOI: https://doi.org/10.1017/S0950268820002071