Relationship of platelet subgroups with prognosis and mortality in patients with mild, severe and critical COVID-19

Abstract

Introduction: This study investigates whether platelet-related indicators including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), Plateletcrit (PCT), and platelet large cell ratio (P-LCR) could be effective biomarkers in the prognostic of 2019-novel coronavirus disease (COVID-19) fatality. 
 Methods: Out of 380 patients diagnosed with COVID-19, 98 patients were randomly and retrospectively were included in our study. Detection of COVID-19 was performed according to the World Health Organization (WHO) guidelines and using quantitative polymer chain reaction (qPCR). Clinical and laboratory data and medical records for all study participants were collected from a digital version of their health history at Ayancik State Hospital and Diyarbakır Gazi Yaşargil Training and Research Hospital. All patients were followed up daily until discharge or death and were eventually classified into three categories: Mild, severe, and critical patients. Data analysis was performed using SPSS-26 for Windows (Statistical Package for Social Science, SPSS Inc. Chicago IL, USA®Z), and a 95% confidence level was selected. P < 0.5 was considered statistically significant.
 Results: Of participants, 64.3% of the patients are 65 years and older, 54.1% are male, 60.2% survived, 39.8 % died and 35.7% are in critical condition. The mortality rate is higher in males and 65 years and older. While PLT (190,24) and PCT (0,21) measurements were higher in surviving patients, MPV (10,67), PDW (16,15) and P-LCR (30,82) measurements were higher in deceased patients. PDW and PCT measurements are more effective in predicting mortality state according to Roc analysis. The measurement that best predicts the deceased status of patients who are positive according to the cut-off value determined is PDW (0.621), and the measurement that best estimates the surviving patients is PLT (0.925).
 Conclusions: In our study, it was concluded that high MPV, PDW and P-LCR and low platelet values are associated with poor prognosis of COVID-19 disease, and PDW and PCT measurements are more effective in predicting mortality in patients with COVID-19 infection. Laboratory parameters such as MPV, PDW, P-LCR, PDW, and PCT can provide clinicians with predictions of prognosis and mortality from COVID-19 disease.