Platelet-Based Biomarkers for Diagnosis and Prognosis in COVID-19 Patients.

Fernanda Cardoso,Luana de Mendonça Oliveira,Rosa Liliana Solis-Castro,Sarah Cristina Gozzi-Silva,Danielle Rosa Beserra,Ricardo Wesley Alberca,Milena Mary de Souza Andrade,Alberto Jose da Silva Duarte,Raquel Leao Orfali,Emily Araujo de Oliveira,Maria Notomi Sato,Valeria Aoki,Nátalli Zanete Pereira,Maria Edith Solis-Castro

doi:10.3390/life11101005

Fernanda Cardoso, Luana de Mendonça Oliveira

Open Access

https://doi.org/10.3390/life11101005

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Abstract

Coronavirus disease 2019 (COVID-19) caused millions of deaths worldwide. COVID-19’s clinical manifestations range from no symptoms to a severe acute respiratory syndrome, which can result in multiple organ failure, sepsis, and death. Severe COVID-19 patients develop pulmonary and extrapulmonary infections, with a hypercoagulable state. Several inflammatory or coagulatory biomarkers are currently used with predictive values for COVID-19 severity and prognosis. In this manuscript, we investigate if a combination of coagulatory and inflammatory biomarkers could provide a better biomarker with predictive value for COVID-19 patients, being able to distinguish between patients that would develop a moderate or severe COVID-19 and predict the disease outcome. We investigated 306 patients with COVID-19, confirmed by severe acute respiratory syndrome coronavirus 2 RNA detected in the nasopharyngeal swab, and retrospectively analyzed the laboratory data from the first day of hospitalization. In our cohort, biomarkers such as neutrophil count and neutrophil-to-lymphocyte ratio from the day of hospitalization could predict if the patient would need to be transferred to the intensive care unit but failed to identify the patients´ outcomes. The ratio between platelets and inflammatory markers such as creatinine, C-reactive protein, and urea levels is associated with patient outcomes. Finally, the platelet/neutrophil-to-lymphocyte ratio on the first day of hospitalization can be used with predictive value as a novel severity and lethality biomarker in COVID-19. These new biomarkers with predictive value could be used routinely to stratify the risk in COVID-19 patients since the first day of hospitalization.

Highlights

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused millions of deaths worldwide
FATAL groups consisted of 75 patients that were initially hospitalized in the general ward (GW) (9 patients) and intensive care unit (ICU) (66 patients) that died due to COVID-19
Laboratory data identified an increase in D-dimer levels in the FATAL group in comparison to GW, but not ICU (Table 1)

Summary

Introduction

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused millions of deaths worldwide. COVID-19 severity degree ranges from asymptomatic to a severe systemic disease with respiratory and/or multiorgan damage, and a clinical course that can rapidly progress to deadly complications [1]. Comorbidities such as respiratory disorders [2], organ transplant recip- 4.0/). Several studies have reported increasing biomarkers in COVID-19 patients, which further increases according to the severity of the disease [5,6,7]. The cytokine storm is characterized by an increase in blood levels of interferon-inducible protein 10 (IP10), monocyte chemoattractant protein (MCP-1), macrophage inflammatory protein (MIP)1A and MIP1B, platelet derived growth factor (PDGF), tumor necrosis factor (TNF), interleukin (IL)-1, IL-7, IL-8, IL-9, and interferon (IFN)γ [5], which contribute to hyper inflammation, increasing the recruitment and activation of immune cells and tissue injury [12,13]

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