The value of the platelet count and platelet indices in differentiation of COVID‐19 and influenza pneumonia

Abstract

It is difficult to distinguish coronavirus disease‐2019 (COVID‐19) from other viral respiratory tract infections owing to the similarities in clinical and radiological findings. This study aims to determine the clinical importance of platelet count and platelet indices in the differentiation of COVID‐19 from influenza and the value of these parameters in the differential diagnosis of COVID‐19. The medical records of the patients and the electronic patient monitoring system were retrospectively analyzed. Demographic characteristics, admission symptoms, laboratory findings, radiological involvement, comorbidities, and mortality of the patients were recorded. Forty‐three patients diagnosed with influenza and 54 diagnosed with COVID‐19 were included in the study. The average age of the COVID‐19 patients was lower than that of the influenza patients (influenza: 60.5 years, COVID‐19: 52.4 years; pp = 0.024),.024), and the male gender was predominant in the COVID‐19 group (influenza: 42%, COVID‐19: 56%). According to laboratory findings, the mean platelet volume (MPV) and MPV/platelet ratio were statistically significantly lower, whereas the eosinophil count and platelet distribution width levels were significantly higher (p < 0.05) in the COVID‐19 group. It was found that the most common symptom in both groups was dyspnea and that the symptom was more prevalent among influenza patients. In the diagnosis of COVID‐19, the platelet count and platelet indices are easily accessible, inexpensive, and important parameters in terms of differential diagnosis and can help in the differentiation of COVID‐19 from influenza during seasonal outbreaks of the latter.

Comparison of clinical and biochemical features of hospitalized COVID‐19 and influenza pneumonia patients

“… 35 , 37 , 38 In our study, MPV levels and MPV/platelet ratio has been shown to decrease whereas the PLT count increased in the COVID‐19 compared with the influenza group. Ozçelik et al 28 have been shown similar results with our study, but without any difference in PLT count. 30 In previous studies, a relationship between platelet count at the time of hospitalization and the severity of the disease was observed for both influenza and COVID‐19 diseases.…”

“… 22 Lymphopenia also would be an important laboratory abnormality characteristic of influenza while viral infections can induce depletion of lymphocytes during the clinical course. 23 , 24 , 25 , 26 Moreover, we confirmed the results of previous studies that both COVID‐19 and influenza decreased the number of lymphocytes, 9 , 10 , 15 , 27 , 28 , 29 but no statistically significant difference was found between study groups. However, a few studies showed that lymphopenia was deeper in the influenza group.…”

“… 9 , 17 , 27 , 30 But even neutropenia associated with the disease or discriminative role for the two viral infections is not clearly detected. 10 , 28 , 29 Therefore, it is not realistic to conclude as suggested by Luo et al 9 using decreased lymphocytes and neutrophils for differentiating COVID‐19 from influenza due to the inconclusive results. Our results did supported that neither lymphopenia nor neutropenia would differentiate COVID‐19 from influenza.…”

A strong correlation exists between platelet consumption and platelet hyperactivation in COVID-19 patients. Pilot study of the patient cohort from CCH RAS Hospital (Troitsk).

“…The observed increase in platelet's size may not be exclusive for patients with SARS-COV-2 virus. A couple of recent studies have demonstrated that platelet count is significantly reduced in influenzainduced pneumonia, and the mean platelet volume is significantly increased [43], [44]. Severe thrombocytopenia is extremely rare for the Epstein-Barr virus, but this infection often presents a mild reduction in platelet counts as well as moderate the size parameter is recalculated from the age parameter: increase in platelet size for uncomplicated cases [45].…”

Immature Platelet Fraction and COVID-19: Maturing prognostic links!

“…While the platelet-related parameters such as mean platelet volume (MPV) and MPV/platelet count ratio have been investigated for their ability to augment the differentiation of COVID-19 from the influenza pneumonia and for the severity prediction in COVID-19 with promising results, the immature platelet fraction (IPF) has received much lesser scrutiny as the platelet activation readouts of prognostic importance in COVID-19. 6,7 Insert RRH Herein, IPF denotes the proportion of the total platelet pool constituted by the young immature reticulated cells and constitutes an important, inexpensive, an automated hematological marker of an accentuated platelet turnover. 1,7 Quite remarkably, the combined account of the initial encouraging literature on the prognostic role of IPF, in septic and prothrombotic clinical settings, endorses a strong case for exploring the predictive abilities in COVID-19.…”