Association between thrombocytopenia and platelet profile with morbidity/mortality of severe and non-severe COVID-19 patients

Abstract

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a novel infectious viral disease that can be associated with changes in platelet counts. Thrombocytopenia is a risk factor for increased mortality and morbidity among these patients. In this study, we aimed to measure the platelet count of COVID-19 patients and find the association with morbidity and mortality after following up. METHODS:This study was conducted on 1,320 confirmed COVID-19 patients who were admitted to the Ayatollah Taleghani and Shohada Tajrish Hospital in Tehran, Iran. The diagnosis of COVID-19 was confirmed by standard protocols. The data on the platelet profile were retrospectively extracted from patients' electronic medical records consisted of platelet counts on admission, the next 7 days during the hospital stay, and on discharge. Patients were categorized into two groups, namely, "non-severe presentation" and "severe presentation" based on clinical signs. RESULTS:There was no significant difference in platelet counts and thrombocytopenia between severe and non-severe, survivors and nonsurvivors, and severe survivors and severe non-survivors groups at the time of admission to the hospital. After 7 days, a trend toward an increase in platelet counts was seen in non-severe patients, survivors, and severe compared with severe patients, non-survivors, and severe non-survivors, respectively.CONCLUSIONS: Thrombocytopenia and thrombotic complications in COVID-19 patients are common and lead to a higher mortality rate.

Patients with COVID-19 Critical Illness Have a Significantly Higher Systemic Immune-Inflammatory Index on Admission

“…The admission platelet in our study showed no significant difference between both the severe and non-severe groups. The results of our study were in accordance with the study by Khave et al (2021), but in their study, after seven days since the day of admission, there was a tendency to increase the platelet count in the non-severe group compared to the severe group.…”

Complex changes in serum protein levels in COVID-19 convalescents

“…As fibrinogen and VWF are engaged in platelet degranulation 44,45 , we hypothesize that the observed decreased levels of proteins from the platelet degranulation pathway in samples from COVID-19 convalescents (Figure 4, cluster A) may be due to low platelet counts resulting from platelet consumption during COVID-19 infection. This hypothesis is supported by studies that suggest a 5% to 42% exhaustion in platelet counts for several months post infection (immune thrombocytopenia) [46][47][48][49] amongst survivors of both severe and non-severe COVID-19 patients [50][51][52][53] . While low platelet counts can occur any time during the acute phase of COVID-19, it has been frequently observed after clinical recovery 54 , e.g.…”

The influence of SARS-CoV-2 on the immune system elements and on the placental structure. Clinical, histological and immunohistochemical study

“…Common hematological abnormalities in patients infected with SARS-CoV-2 include changes in the number of platelets, white blood cells, Hb, coagulation/fibrinolytic changes and lymphopenia [ 51 ]. Low lymphocytes, low platelets, and clotting problems are the most common hematological disorders [ 52 , 53 , 54 ]. Understanding the hematological characteristics of patients with COVID-19 may help with early triage and prediction of disease severity [ 47 , 52 , 53 ].…”

“…Low lymphocytes, low platelets, and clotting problems are the most common hematological disorders [ 52 , 53 , 54 ]. Understanding the hematological characteristics of patients with COVID-19 may help with early triage and prediction of disease severity [ 47 , 52 , 53 ]. In this study, there were no significant differences between the two groups regarding the mean values of Hb or leukocytes.…”