High Mean Platelet Volume and Mean Platelet Volume/Platelet Ratio Predict Mortality for COVID-19 Patients in Intensive Care Unit

Yıl 2022, Cilt: 3 Sayı: 2, 75 - 82, 16.09.2022

Emel Sağlam , Saime Özbek Şebin , Songül Koçman , Cem Cemal Balaban , Can Yücelsen , Ahmet Engin Atay

https://doi.org/10.56766/ntms.1127805

Öz

Background: Mean platelet volume to platelet count ratio can be a new marker of mortality in critical COVID-19 cases in intensive care unit to retrospectively examine the factors predicting death rate in COVID-19 cases.
Methods: 106 patients infected with COVID-19 in intensive care unit were enrolled in this research. The patients’ hospital records and the patient management devices were thoroughly examined.
Results: The Interleukin-6, C-reactive protein, procalcitonin, leukocyte count, neutrophil count, neutrophil %, neutrophil/lymphocyte ratio, and neutrophil/albumin ratio were significantly higher among nonsurvivors (respective results are as follows: p=0.0001, p=0.004, p=0.003, p=0.049, p=0.007, p=0.009, p=0.007 and p=0.0001). While the survivors had lower widths of platelet distribution and red blood cell distribution, as well as mean platelet volume and mean platelet volume to platelet count ratio (respective results are as follows: p=0.016, p=0.03, p=0.005 and p=0.049), hemoglobin, platelet, mean corpuscular hemoglobin concentration, lymphocyte % ve monocyte % were higher (respective results are as follows: p=0.022, p=0.033, p=0.042, p=0.008 and p=0.04). In the logistic regression, five features -including high levels of C-reactive protein, procalcitonin, pro-brain natriuretic peptide, mean platelet volum to platelet count ratio, and low level of platelet were shown as mortality predictors for COVID-19 patients in intensive care unit (respective results are as follows: p=0.045, p=0.025, p=0.017, p=0.027 and p=0.041).
Conclusion: Mean platelet volume to platelet count ratio, neutrophil count/lymphocyte count, neutrophil count/albumin ratio predict mortality in critical cases of COVID-19 which will contribute to early detection and effective treatment to improve the survival of the patients.

Anahtar Kelimeler

COVID-19, mortality, mean platelet volume, platelet, mortality

Destekleyen Kurum

No financial support was received for this study.

Kaynakça

• Referans1. Guan W, Ni Z, Hu Y, Liang W, Ou C, et al. China Medical Treatment Expert Group for Covid-19 Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708–1720.
• Referans2. Huang C, Wang Y, Li X, Ren L, Zhao J, et al. Clinical features of patients infected with 2019 novel coronavirus in wuhan, china. Lancet. 2020;395(10223):497–506.
• Referans3. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20: 533–534.
• Referans4. Jiang X, Rayner S, Luo MH. Does sars-cov-2 has a longer incubation period than sars and mers? J Med Virol. 2020.
• Referans5. World Health Organization Coronavirus Disease 2019 (COVID-19) Situation Reports: Weekly Epidemiological Update, https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---5-april-2022.
• Referans6. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24;1239–1242.
• Referans7. Wander PL, Orlov M, Merel SE, Enquobahrie DA. Risk factors for severe COVID-19 illness in healthcare workers: Too many unknowns. Infect Control HospEpidemiol. 2020 Apr 27;1–2.
• Referans8. Cen Y, Chen X, Shen Y, Zhang X, Lei Y, et al. Risk factors for disease progression in patients with mild to moderate coronavirus disease 2019-a multi-centre observational study. ClinMicrobiol Infect. 2020 Jun 09;1242–1247.
• Referans9. Zhou F, Yu T, Du R, Fan G, Liu Y, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054–1062.
• Referans10. Liu D, Wang Y, Wang J, Liu J, Yue Y, et al. Characteristics and Outcomes of a Sample of Patients With COVID-19 Identified Through Social Media in Wuhan, China: Observational Study. J Med Internet Res. 2020 Aug 13;22(8): e20108.
• Referans11. Li J, Chen Z, Nie Y, Ma Y, Guo Q, et al. Identification of Symptoms Prognostic of COVID-19 Severity: Multivariate Data Analysis of a Case Series in Henan Province. J Med Internet Res. 2020 Jun 30;22(6): e19636.
• Referans12. Wu JT, Leung K, Bushman M, Kishore N, Niehus R, et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med. 2020 Apr;26(4):506–510.
• Referans13. Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020 May 26;323(20):2052–2059.
• Referans14. Pan P, Li Y, Xiao Y, Han B, Su L, et al. Prognostic Assessment of COVID-19 in the Intensive Care Unit by Machine Learning Methods: Model Development and Validation.J Med Internet Res. 2020 Nov; 22(11): e23128.
• Referans15. Lu J, Hu S, Fan R, Liu Z, Yin X, et al. ACP Risk Grade: A Simple Mortality Index for Patients with Confirmed or Suspected Severe Acute Respiratory Syndrome Coronavirus 2 Disease (COVID-19) During the Early Stage of Outbreak in Wuhan, China. SSRN Journal. Preprint posted online on February 28, 2020.
• Referans16. Cheng JW, Cao Y, Xu Z, Tan Z, Zhang X, et al. Development and Evaluation of an AI System for COVID-19 Diagnosis. medRxiv. Preprint posted online on June 02, 2020.
• Referans17. Zhang Y, Zeng X, Jiao Y, Li Z, Liu Q, et al. Mechanisms involved in the development of thrombocytopenia in patients with COVID-19. Thromb Res. 2020;193:110–115.
• Referans18. Zhong Q, Peng J. Zhong Q, Peng J. Mean platelet volume/platelet count ratio predicts severe (Epub ahead of print) J Clin Lab Anal. 2020:0.
• Referans19. World Health Organization. Cumulative Number of Reported Probable Cases of Severe Acute Respiratory Syndrome (SARS). https://www.who.int/csr/sars/country/en/. Accessed 04/18, 2020.
• Referans20. World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV). https://www.who.int/emergencies/mers-cov/en. Accessed 04/18, 2020.
• Referans21. Chen N, Zhou M, Dong X, Qu J, Gong F, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513.
• Referans22. Wang D, Hu B, Hu C, Zhu F, Liu X, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020.
• Referans23. Zhou F, Yu T, Du R, Fan G, Liu Y, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054–1062.
• Referans24. Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, et al. Risk Factors for Mortality in Patients with COVID-19 in New York City. J Gen Intern Med. 2021 Jan; 36(1): 17–26.Published online 2020 Jun 30.
• Referans25. Li J, He X, Yuan Y, Zhang W, Li X, et al. Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Am J Infect Control. 2021 Jan; 49(1): 82–89. Published online 2020 Jun 12.
• Referans26. Iaccarino G, Grassi G, Borghi C, Ferri C, Salvetti M, et al. SARS-RAS Investigators. Age and Multimorbidity Predict Death Among COVID-19 Patients: Results of the SARS-RAS Study of the Italian Society of Hypertension. Hypertension. 2020 Aug; 76(2):366-372.
• Referans27. Guan X, Zhang B, Fu M, Li M, Yuan X, et al. Clinical and inflammatory features based machine learning model for fatal risk prediction of hospitalized COVID-19 patients: results from a retrospective cohort study. Ann Med. 2021; 53(1): 257–266.
• Referans28. Azoulay E, Fartoukh M, Darmon M, Géri G, Voiriot G, et al. Increased mortality in patients with severe SARS-CoV-2 infection admitted within seven days of disease onset. Intensive Care Med. 2020 Aug 11: 1–9.
• Referans29. Shivakumar BG, Gosavi S, Rao AA, Shastry S, Raj SC, et al. Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, and Platelet-to-Lymphocyte Ratios: Prognostic Significance in COVID-19. Cureus. 2021 Jan; 13(1): e12622. Published online 2021 Jan 11.
• Referans30. Zhang G, Zhang J, Wang B, Zhu X, Wang Q, et al. Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis. Respir Res. 2020; 21: 74. Published online 2020 Mar 26.
• Referans31. Liang W, Liang H, Ou L, Chen B, Chen A, et al. MD for the China Medical Treatment Expert Group for COVID-19. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020 Aug; 180(8): 1–9. Published online 2020 May 12.
• Referans32. Wang H, Zhang Y, Mo P, Liu J, Wang H, et al. Neutrophil to CD4+ lymphocyte ratio as a potential biomarker in predicting virus negative conversion time in COVID-19. IntImmunopharmacol. 2020; 85: 106683.
• Referans33. Yan X, Li F, Wang X, Yan J, Zhu F, et al. Neutrophil to lymphocyte ratio as prognostic and predictive factor in patients with coronavirus disease 2019: a retrospective cross-sectional study. J Med Virol. 2020;10.1002/jmv.26061.
• Referans34. Varim C, Yaylaci S, Demirci T, Kaya T, Nalbant A, et al. Neutrophil count to albumin ratio as a new predictor of mortality in patients with COVID-19 ınfection. Rev Assoc Med Bras (1992). 2020 Sep 21;66Suppl 2(Suppl 2):77-81.
• Referans35. Ji D, Zhang D, Xu J, Chen Z, Yang T, et al. Prediction for progression risk in patients with COVID-19 pneumonia: the CALL Score. Clin Infect. 2020;71(6):1393–1399.
• Referans36. Han H, Ma Q, Li C, Liu R, Zhao L, et al. Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors. Emerg Microbes Infect. 2020;9(1):1123–1130.
• Referans37. Ali S, Chaudry SS, Khan AQ, Shiekh AK, Tariq J, et al. Dynamics of hemogram and biochemical parameters in COVID-19 patients and their implication-A single-center prospective study in tertiary care hospital Islamabad, Pakistan. Int J Lab Hematol. 2020 Dec 30.
• Referans38. Gong J, Ou J, Qiu X, Jie Y, Chen Y, et al. (COVID-19): a multicenter study using the risk nomogram in Wuhan and Guangdong, China. Clin Infect Dis. 2020;71(15):833-840.
• Referans39. Wang C, Deng R, Gou L, Fu Z, Zhang X, et al. Preliminary study to identify severe from moderate cases of COVID-19 using combined hematology parameters. Ann Transl Med. 2020;8(9):593.
• Referans40. Gao Y, Li Y, Yu X, Guo S, Ji X, et al. The impact of various platelet indices as prognostic markers of septic shock. PLoS One. 2014 Aug 13;9(8): e103761. Referans41. Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol. 2020 Jun;99(6):1205-1208. doi: 10.1007/s00277-020-04019-0. Epub 2020 Apr 15.
• Referans42. Ozcelik N, Ozyurt S, Yilmaz Kara B, Gumus A, Sahin U. The value of the platelet count and platelet indices in differentiation of COVID-19 and influenza pneumonia.J Med Virol. 2021 Apr;93(4):2221-2226.
• Referans43. Wong RS, Wu A, To KF, Lee N, Lam WKC, et al. Haematological manifestations in patients with severe acute respiratory syndrome: retrospective analysis. BMJ. 2003;326(7403):1358–1362.
• Referans44. Asano S, Okano A, Ozawa K, Nakahata T, Ishibashi T, et al. In vivo effects of recombinant human interleukin-6 in primates: stimulated production of platelets. Blood. 1990 Apr 15;75(8):1602-5.
• Referans45. Yang M, Ng MH, Li CK. Thrombocytopenia in patients with severe acute respiratory syndrome (review) Hematology. 2005;10(2):101–105.
• Referans46. Handtke S, Thiele T. Large and small platelets-(When) do they differ? J Thromb Haemost. 2020. pmid:32108994
• Referans47. Sharma K, Yadav A. Association of Mean Platelet Volume with Severity, Serology & Treatment Outcome in Dengue Fever: Prognostic Utility. J ClinDiagn Res. 2015;9(11):EC01–EC3.
• Referans48. Comer SP, Cullivan S, Szklanna PB, Weiss L, Cullen S, et al. COCOON Study investigators. COVID-19 induces a hyperactive phenotype in circulating platelets. PLoS Biol. 2021 Feb 17;19(2): e3001109.
• Referans49. Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, et al Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras (1992). 2020 Aug;66(8):1122-1127.
• Referans50. Gençay I, Büyükkoçak Ü, Gökay A, Çağlayan O. Mean platelet volüme and platelet distribution width as mortality predictors in intensive care unit. J Health Sci Med 2020:3(1):51-55.