Evaluation of plateletcrit level from platelet indices as a prognostic marker in COVID-19 patients

Eur Rev Med Pharmacol Sci. 2023 Oct;27(19):9429-9437. doi: 10.26355/eurrev_202310_33971.

Abstract

Objective: COVID-19 disease bears similarities to a wide range of diseases, from simple flu infections to severe acute respiratory distress syndrome and is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this study, we aimed to elucidate the plateletcrit levels in patients with and without mortality who had been admitted to the intensive care unit because of pneumonia associated with SARS-CoV-2.

Patients and methods: In total, 434 patients were evaluated in this retrospective analysis. Their demographic data, comorbid diseases, Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, platelet, lymphocyte, white blood cell (WBC) and neutrophil counts; mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), hemoglobin and C-reactive protein (CRP) levels and neutrophil-lymphocyte ratios (NLRs) were obtained from the hospital's electronic database on the days of the patients' intensive care unit admissions. Afterwards, their PLR, PNR, and MPV/PLT ratios were calculated.

Results: APACHE II score, length of hospital stay, WBC count, PCT, PLR, NLR, and CRP levels affected mortality. Increases in hospital stay duration, APACHE II score, platelet-lymphocyte ratio (PLR), and CRP, as well as decreases in PCT percentage, were associated with mortality. ROC curve analysis was performed to determine the success of PCT, PLR, and NLR in predicting mortality in COVID-19 patients and to determine cut-off values for mortality. It was determined that PCT, PLR, and NLR could correctly classify patients at rates of 58.9%, 59.2%, and 66.8% (moderate), respectively. The risk of mortality was higher in patients with PCT values of 0.188 or less, PLR values greater than 293.46, and NLR values greater than 9.49.

Conclusions: In the COVID-19 patients evaluated in this study, plateletcrit indices could be utilized to predict mortality.

MeSH terms

  • Blood Platelets
  • COVID-19*
  • Humans
  • Prognosis
  • Retrospective Studies
  • SARS-CoV-2