Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients

PeerJ

article

Yang Yuan¹  Gang Wang¹  Xi Chen²  Xiao-Lei Ye¹  Xiao-Kun Li¹  Rui Li³  Wan-Li Jiang⁵  Hao-Long Zeng⁶  Juan Du⁷  Xiao-Ai Zhang¹  Hao Li¹  Li-Qun Fang¹  Qing-Bin Lu⁷  Wei Liu¹ 

[1] State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology;Department of Thoracic and Vascular Surgery, Wuhan First Hospital, Tongji Medical College, Huazhong University of Science and Technology;Department of Healthcare, School of Health Sciences, Wuhan University;Global Health Institute, Wuhan University;Department of Thoracic Surgery, Renmin Hospital of Wuhan University;Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;Department of Laboratorial Science and Technology, School of Public Health, Peking University

关键词: Thrombocytopenia;    COVID-19;    Adverse outcome;    Mortality;    China;   

DOI  :  10.7717/peerj.13608

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundThrombocytopenia was common in the coronavirus disease 2019 (COVID-19) patients during the infection, while the role of thrombocytopenia in COVID-19 pathogenesis and its relationship with systemic host response remained obscure. The study aimed to systematically evaluate the relationship between thrombocytopenia in COVID-19 patients and clinical, haematological and biochemical markers of the disease as well as adverse outcomes.MethodsTo assess the relationship between abnormal platelet levels and disease progression, a multi-center retrospective cohort study was conducted. COVID-19 patients with thrombocytopenia and a sub-cohort of matched patients without thrombocytopenia were compared for their clinical manifestations, haematological disorders, biochemical parameters, inflammatory markers and clinical outcome.ResultsThrombocytopenia was present in 127 of 2,209 analyzed patients on admission. Compared with the control group, thrombocytopenia patients developed significantly higher frequency of respiratory failure (41.9% vs. 22.6%, P = 0.020), intensive care unit entrance (25.6% vs. 11.5%, P = 0.012), disseminated intravascular coagulation (45.2% vs. 10.6%, P < 0.001), more altered platelet morphology indexes and coagulation perturbation, higher levels of inflammatory markers. In addition, a significantly increased all-cause mortality (hazard ratio 3.08, 95% confidence interval 2.26–4.18, P < 0.001) was also observed in the patients with thrombocytopenia. Late development of thrombocytopenia beyond 14 days post-symptom was observed in 61 patients, from whom a comparable mortality rate yet longer duration to death was observed compared to those with early thrombocytopenia.ConclusionsOur finding from this study adds to previous evidence that thrombocytopenia is associated with adverse outcome of the disease and recommend that platelet count and indices be included alongside other haematological, biochemical and inflammatory markers in COVID-19 patients’ assessment during the hospital stay.

【 授权许可】

CC BY