Thrombocytopenia and its association with mortality in patients with COVID-19

J Thromb Haemost. 2020 Jun;18(6):1469-1472. doi: 10.1111/jth.14848. Epub 2020 May 4.

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes novel coronavirus disease 2019 (COVID-19), is spreading rapidly around the world. Thrombocytopenia in patients with COVID-19 has not been fully studied.

Objective: To describe thrombocytopenia in patients with COVID-19.

Methods: For each of 1476 consecutive patients with COVID-19 from Jinyintan Hospital, Wuhan, China, nadir platelet count during hospitalization was retrospectively collected and categorized into (0, 50], (50, 100], (100-150], or (150-) groups after taking the unit (×109 /L) away from the report of nadir platelet count. Nadir platelet counts and in-hospital mortality were analyzed.

Results: Among all patients, 238 (16.1%) patients were deceased and 306 (20.7%) had thrombocytopenia. Compared with survivors, non-survivors were older, were more likely to have thrombocytopenia, and had lower nadir platelet counts. The in-hospital mortality was 92.1%, 61.2%, 17.5%, and 4.7% for (0, 50], (50, 100], (100-150], and (150-) groups, respectively. With (150-) as the reference, nadir platelet counts of (100-150], (50, 100], and (0, 50] groups had a relative risk of 3.42 (95% confidence interval [CI] 2.36-4.96), 9.99 (95% CI 7.16-13.94), and 13.68 (95% CI 9.89-18.92), respectively.

Conclusions: Thrombocytopenia is common in patients with COVID-19, and it is associated with increased risk of in-hospital mortality. The lower the platelet count, the higher the mortality becomes.

Keywords: COVID-19; SARS-CoV-2; generalized linear model; mortality; thrombocytopenia.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • China
  • Coronavirus Infections / blood
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / virology
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Platelet Count
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / virology
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2
  • Thrombocytopenia / blood
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / mortality*
  • Thrombocytopenia / virology