Platelet and large platelet ratios are useful in predicting severity of COVID-19

Int J Hematol. 2024 Jun;119(6):638-646. doi: 10.1007/s12185-024-03737-9. Epub 2024 Mar 23.

Abstract

The role of platelets in coronavirus disease (COVID-19) severity requires further exploration. To determine whether the platelet index is useful in predicting COVID-19 severity, we compared the platelet index in patients with higher and lower oxygen requirements (≥ 4 L/min vs. < 4 L/min) and patients without COVID-19. We also analyzed the time course of the platelet index in each group. A total of 285 patients with COVID-19 and 36 without COVID-19 who were hospitalized at Fussa Hospital were analyzed. After matching for oxygen requirement at admission, multivariate analysis was performed. Platelets (≤ 16.6 × 104/μL) and platelet-large cell ratio (P-LCR) (≥ 27.8%) were significant factors influencing severity. Based on these factors, we created the Fussa platelet score, and the group with a Fussa platelet score ≥ 2 was significantly more likely to reach the 4 L/min oxygen requirement (event-free survival: Fussa platelet score ≥ 2 versus < 2, P < 0.00000001). Analysis of platelet index by time period showed a significant increase from 6-10 days after onset. The Fussa platelet score can be measured quickly, easily, and inexpensively in a clinic and may be useful in determining need for transfer to a critical care hospital.

Keywords: COVID-19; Platelet index; Platelet-large cell ratio; Prognostic factor; Risk-prediction score.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Platelets* / pathology
  • COVID-19* / blood
  • COVID-19* / diagnosis
  • COVID-19* / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Prognosis
  • Retrospective Studies
  • SARS-CoV-2*
  • Severity of Illness Index*