Thrombocytopenia and clinical outcomes among patients with COVID‐19 disease: A cohort study

Alkhalifa, Hussain; Alsalman, Zaenb; Alfaraj, Aman; Algaraash, Mohammed Mahdi; Alsalman, Mortadah

doi:10.1002/hsr2.1111

Cited by 3 publications

(5 citation statements)

References 23 publications

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“…This exacerbates the inflammatory responses and renal impairment [32]. Lower platelet counts are associated with AKI [33]. Our study found a J-shaped association between the SII and SA-AKI, with higher mortality in the Q1 group than in the Q2 control group, although the difference was not statistically significant.…”

contrasting

confidence: 44%

Systemic Immune-Inflammation Index (SII) as a Predictor of Short-Term Mortality Risk in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study

Sun,

Qi,

Wang

et al. 2024

Med Sci Monit

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Background:Sepsis-associated acute kidney injury (SA-AKI) is linked to high mortality rates and an unfavorable prognosis.Early identification of patients with poor prognosis is crucial. This study aimed to investigate the relationship between the systemic immune-inflammation index (SII) and mortality in this specific patient population. Material/Methods:This retrospective cohort study used data from the Medical Information Mart for Intensive Care IV database. Data on patient demographics, comorbidities, vital signs, laboratory parameters, treatment usage, acute kidney injury staging, and renal replacement therapy were collected within 48 h of intensive care unit admission.Restricted cubic splines, Kaplan-Meier curves, and Cox regression models were used for analysis. Stratified analyses were performed on the basis of various factors. Results:In total, 7856 patients were included, with a median age of 66.9 years and a male-to-female ratio of 57.7%-42.3%. A J-shaped relationship was observed between SII and mortality risk. The lowest mortality risk occurred at an SII of 760.078×10 9 /L. Compared to the reference group (second quartile of SII), the highest and third quartiles had increased 28-day mortality risk, with adjusted hazard ratios (HRs) of 1.33 (1.16-1.52) and 1.55 (1.36-1.77), respectively. Although a trend towards higher mortality hazard was observed in the lowest SII group (Q1), it was not statistically significant, with an adjusted HR of 1.15 (1-1.32). Conclusions:In patients with SA-AKI, both low and high SII were associated with increased short-term mortality risk. The lowest mortality risk was observed at an SII of 760.078×10 9 /L within a 28-day period.

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contrasting

confidence: 44%

Systemic Immune-Inflammation Index (SII) as a Predictor of Short-Term Mortality Risk in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study

Sun,

Qi,

Wang

et al. 2024

Med Sci Monit

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“…33.3% (3/9) of TMA patients developed AKI. Alkhalifa et al noted that thrombocytopenia was closely linked with and significantly predicted AKI 6 . Our results seem to confirm their observation; in fact, AKI in patients with COVID-19 is common, and COVID-19 AKI is associated with high mortality in these patients 6 , 32 .…”

Section: Discussionmentioning

confidence: 99%

“…Alkhalifa et al noted that thrombocytopenia was closely linked with and significantly predicted AKI 6 . Our results seem to confirm their observation; in fact, AKI in patients with COVID-19 is common, and COVID-19 AKI is associated with high mortality in these patients 6 , 32 . Many potential causes, such as interstitial nephritis, collapsing glomerulopathy, TMA, and acute tubular necrosis (ATN), may be considered possible causes of renal failure associated with COVID-19 infection 33 .…”

Section: Discussionmentioning

confidence: 99%

“…Critically ill patients often experience hypoxic respiratory failure, shock, and multiple organ dysfunction. COVID-19 is known to cause abnormalities in certain hematological parameters, lymphopenia, thrombocytopenia, thromboses, and coagulopathy 4 - 6 . Thrombotic phenomena such as deep venous thrombosis and pulmonary thromboembolism were also seen in critically ill patients 7 .…”

Section: Introductionmentioning

confidence: 99%

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Thrombocytopenia Secondary to COVID-19: Outcomes Analysis in Terms of Thrombotic Microangiopathy, Acute Kidney Injury, and Mortality

Gheiasi,

Taghinezhad,

Patel

et al. 2024

IJHOSCR

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Background: COVID-19 usually complicates respiratory failure; microvascular, macrovascular, and renal complications are common. Both micro and macrovascular complications are associated with multi-organ dysfunction and in-hospital mortality. Thrombotic microangiopathy (TMA) causes microvascular thromboses associated with organ failure, including acute kidney injury (AKI). Materials and Methods: This Retrospective Cohort study included 100 COVID-19 patients with thrombocytopenia, followed up in a university hospital’s intensive care unit (ICU). The primary endpoints were in-hospital mortality or discharge from the hospital and assessing the occurrence of TMA and AKI during the hospitalization. The effect of thrombotic microangiopathy and acute kidney injury on mortality was investigated using logistic regression models in Stata software version 12.1. Results: The TMA and AKI were associated with in-hospital mortality in COVID-19 patients presenting with thrombocytopenia in multivariate regression analysis, adjusted for other variables. The effect of AKI on mortality was obtained (adjusted OR 4.09, 95% CI: 1.33–12.53, p = 0.01). Moreover, the odds of mortality due to TMA were ten-fold higher in the patients who had TMA than those who did not (adjusted OR 10.26, 95% CI: 1.26–83.76, p = 0.03). Conclusion: We outlined TMA in COVID-19 patients, which could be responsible for kidney injury and mortality in critically COVID-19 patients.

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“…Moreover, since our study spanned from before COVID-19 (2013-2019) until 3 years during/after COVID-19 (2020-2022), patients with COVID-19 would have been only included from the last 3 years of the study, which may have created an imbalance in the distribution of patients across the study period. Nonetheless, a study by Alkhalifa, et al found that exposure to linezolid increased the likelihood of thrombocytopenia in patients with COVID-19 (chi-square p < 0.05); though, the authors did not mention the number of patients who received linezolid among the 256 included patients [39]. Therefore, it is suggested to assess the impact of a current or previous episode of COVID-19 on the incidence of thrombocytopenia in patients receiving linezolid.…”

Section: Discussionmentioning

confidence: 99%

Linezolid-Associated Thrombocytopenia: Assessment of Risk Factors in Patients without Hemato-Oncologic Diseases

Thabit,

Alghamdi,

Alsaeed

et al. 2024

JCM

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Background: Linezolid is used for Gram-positive bacterial infections. Thrombocytopenia is one of its main adverse effects resulting from myelosuppression. Several studies have assessed risk factors that may increase the risk of this adverse effect. However, most studies included patients with hemato-oncologic diseases, which may confound such assessments. This study aimed to investigate risk factors for linezolid-associated thrombocytopenia in patients without hemato-oncologic diseases. Methods: This was a multicenter retrospective case-control study of adult patients treated with linezolid twice daily for ≥3 days. Patients with hemato-oncologic diseases, active dengue fever, active COVID-19, baseline platelet count <100 × 103/mm3, concurrent therapy with trimethoprim/sulfamethoxazole or valproic acid, and a recent platelet transfusion within 7 days were excluded. Thrombocytopenia was defined as a drop in platelet count below 100 × 103/mm3. Results: Out of 158 evaluated patients, 33 developed thrombocytopenia, indicating an incidence rate of 20.9%. Of all the risk factors assessed, creatinine clearance of <60 mL/min and bacteremia/infective endocarditis were significantly associated with linezolid-associated thrombocytopenia (adjusted odds ratios, 3.25 and 5.95; 95% CI 1.12–9.45 and 1.23–28.66; p = 0.031 and 0.026, respectively). End of therapy platelet counts were significantly lower in the cases than in the controls (79 vs. 243 × 103/mm3; p < 0.001). Similarly, the percentage of platelet count change was significantly different (−55.1% vs. −10.2%; p < 0.001). Conclusions: In our study, the incidence rate of linezolid-associated thrombocytopenia was 20.9%, and we found that patients with renal impairment and bacteremia may need close monitoring of platelet counts. Prospective studies are warranted to evaluate the potential need for renal dose adjustment.

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Thrombocytopenia and clinical outcomes among patients with COVID‐19 disease: A cohort study

Cited by 3 publications

References 23 publications

Systemic Immune-Inflammation Index (SII) as a Predictor of Short-Term Mortality Risk in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study

Systemic Immune-Inflammation Index (SII) as a Predictor of Short-Term Mortality Risk in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study

Thrombocytopenia Secondary to COVID-19: Outcomes Analysis in Terms of Thrombotic Microangiopathy, Acute Kidney Injury, and Mortality

Linezolid-Associated Thrombocytopenia: Assessment of Risk Factors in Patients without Hemato-Oncologic Diseases

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