Platelet Indices as Potential Monitoring Biomarkers in COVID-19: A New Hope

  • Attika Khalid Foundation university medical college/fauji foundation hospital rawalpindi
  • Sami Saeed
  • Madeeha Rehan
  • Nadia Arif
Keywords: COVID-19, Mean Platelet Volume, Platelet large cell ratio.

Abstract

Objective: To investigate the relationship between established acute inflammatory markers in COVID-19 patients with Mean platelet volume (MPV) and Platelet large cell ratio (P-LCR).

Materials and Methods: This was a retrospective longitudinal study conducted at Fauji Foundation Hospital, Rawalpindi from 10th June to 10th August 2020. Biochemical parameters i.e. CRP, serum ferritin, LDH, and pro-BNP as well as hematological parameters (MPV and P-LCR) were noted once every week during admission of all the COVID-19 positive patients.
Data were analyzed using IBM-SPSS version 23. Repeated measure ANOVA using a generalized linear model was done to check the trend of values during the duration of their stay. Pearson Correlation analysis and regression models were estimated to check the relationship of MPV and P-LCR with C- reactive protein, serum Ferritin, LDH, and pro-BNP. P-values less than 0.05 were considered statistically significant.

Results: The mean age of the studied group was 55.47 (SD=±15.0) years with the female to male ratio being 2:1. Mean platelet volume showed a statistically significant positive correlation with the established set of inflammatory markers other than pro-BNP with a p-value of less than 0.05.P-LCR however showed a positive correlation with CRP (p-value of less than 0.05) only with no significant correlation with other biochemical markers.

Conclusion: MPV is reported on routine complete blood count report (CBC). It is readily available at even the most under-resourced health centers; therefore reporting the platelet indices does not require extra testing, sampling, or reagent cost. A statistically significant positive correlation amongst the established acute inflammatory markers and relatively understudied platelet indices (MPV) in COVID-19 provides a cost-effective, readily available, and time-efficient tool for marking disease progression.

References

1. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19. J Thromb Haemost. 2020 Sep;18(9):2103-2109. DOI: 10.1111/jth.14975. Epub 2020 Jul 21. PMID: 32558075; PMCID: PMC7323352.
2. Lazzaroni MG, Piantoni S, Masneri S, Garrafa E, Martini G, Tincani A, Andreoli L, Franceschini F. Coagulation dysfunction in COVID-19: The interplay between inflammation, viral infection and the coagulation system. Blood Rev. 2020 Aug 24:100745. DOI: 10.1016/j.blre.2020.100745. Epub ahead of print. PMID: 32868115; PMCID: PMC7444609.
3. Abid K., Bari Y.A., Younas M., Tahir Javaid S., Imran A. Progress of COVID-19 epidemic in Pakistan. Asia Pac J Public Health. 2020;32(4):154–156 DOI: 10.1177/1010539520927259
4. Kang Y, Xu S. Comprehensive overview of COVID-19 based on current evidence. Dermatol Ther. 2020 Sep;33(5):e13525. DOI: 10.1111/dth.13525. Epub 2020 May 22. PMID: 32378801; PMCID: PMC7267400.
5. Lippi G, Plebani M. A modern and pragmatic definition of Laboratory Medicine. Clin Chem Lab Med. 2020 Jul 28;58(8):1171. DOI: 10.1515/cclm-2020-0114. PMID: 32069231.
6. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020 Jun 25;58(7):1131-1134. DOI: 10.1515/cclm-2020-0198. PMID: 32119647.
7. Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020 Jul;84:106504. DOI: 10.1016/j.intimp.2020.106504. Epub 2020 Apr 13. PMID: 32304994; PMCID: PMC7152924.
8. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V.. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators of Inflammation. 2019;2019: 1-14. DOI:10.1155/2019/9213074.
9. Guclu E, Durmaz Y, Karabay O. Effect of severe sepsis on platelet count and their indices. Afr Health Sci. 2013 Jun;13(2):333-8. DOI: 10.4314/ahs.v13i2.19. PMID: 24235932; PMCID: PMC3824485.
10. Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, Yaylacı S, Koroglu M, Uzun C, Karabay O. Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras (1992). 2020 Aug;66(8):1122-1127. DOI: 10.1590/1806-9282.66.8.1122. PMID: 32935808.
11. Nurkalem Z, Alper AT, Orhan AL, Zencirci AE, Sari I, Erer B, Aksu HU, Ergün DS, Yilmaz HY, Eren M. Mean platelet volume in patients with slow coronary flow and its relationship with clinical presentation. Turk Kardiyol Dern Ars. 2008 Sep;36(6):363-7. PMID: 19155638.
12. Tajarernmuang P, Phrommintikul A, Limsukon A, Pothirat C, Chittawatanarat K. The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis. Crit Care Res Pract. 2016;2016:4370834. DOI:10.1155/2016/4370834
13. Zhong Q, Peng J. Mean platelet volume/platelet count ratio predicts severe pneumonia of COVID-19. J Clin Lab Anal. 2021 Jan;35(1):e23607. DOI: 10.1002/jcla.23607. Epub 2020 Oct 31. PMID: 33128497; PMCID: PMC7843293.
14. Gao Y, Li Y, Yu X, Guo S, Ji X, Sun T, Lan C, Lavergne V, Ghannoum M, Li L. The impact of various platelet indices as prognostic markers of septic shock. PLoS One. 2014 Aug 13;9(8):e103761. DOI: 10.1371/journal.pone.0103761. Erratum in: PLoS One. 2015;10(2):e0117889. PMID: 25118886; PMCID: PMC4131909.
15. Pogorzelska K, Krętowska A, Krawczuk-Rybak M, Sawicka-Żukowska M. Characteristics of platelet indices and their prognostic significance in selected medical condition - a systematic review. Adv Med Sci. 2020 Sep;65(2):310-315. DOI: 10.1016/j.advms.2020.05.002. Epub 2020 Jun 4. PMID: 32505856.
16. Pogorzelska K, Krętowska A, Krawczuk-Rybak M, Sawicka-Żukowska M. Characteristics of platelet indices and their prognostic significance in selected medical condition–a systematic review. Advances in Medical Sciences. 2020 Sep 1;65(2):310-5. https://doi.org/10.1016/j.advms.2020.05.002
17. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. DOI: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Jan 30;: PMID: 31986264; PMCID: PMC7159299.
18. Zhang S, Liu Y, Wang X, Yang L, Li H, Wang Y, Liu M, Zhao X, Xie Y, Yang Y, Zhang S, Fan Z, Dong J, Yuan Z, Ding Z, Zhang Y, Hu L. SARS-CoV-2 binds platelet ACE2 to enhance thrombosis in COVID-19. J Hematol Oncol. 2020 Sep 4;13(1):120. DOI: 10.1186/s13045-020-00954-7. PMID: 32887634; PMCID: PMC7471641.
19. Fan Z, Pan J, Zhang Y, Wang Z, Zhu M, Yang B, Shi L, Jing H. Mean Platelet Volume and Platelet Distribution Width as Markers in the Diagnosis of Acute Gangrenous Appendicitis. Dis Markers. 2015;2015:542013. DOI: 10.1155/2015/542013. Epub 2015 Nov 25. PMID: 26688600; PMCID: PMC4673334.
20. Catal F, Tayman C, Tonbul A, Akça H, Kara S, Tatli MM, Oztekin O, Bilici M. Mean platelet volume (MPV) may simply predict the severity of sepsis in preterm infants. Clin Lab. 2014;60(7):1193-200. DOI: 10.7754/clin.lab.2013.130501. PMID: 25134389.
21. Ozder A. A novel indicator predicts 2019 novel coronavirus infection in subjects with diabetes. Diabetes Res Clin Pract. 2020;166:108294. doi:10.1016/j.diabres.2020.108294
22. Liu Y, Sun W, Guo Y, et al. Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study. Platelets. 2020;31(4):490-496. DOI: 10.1080/09537104.2020.1754383
23. Cuma Mertoglu, Mehmet Tahir Huyut, Yusuf Arslan, Yasar Ceylan & Taha Abdulkadir Coban (2021) How do routine laboratory tests change in coronavirus disease 2019?, Scandinavian Journal of Clinical and Laboratory Investigation, 81:1, 24-33, DOI: 10.1080/00365513.2020.1855470.
Published
2021-03-30
How to Cite
1.
Khalid A, Saeed S, Rehan M, Arif N. Platelet Indices as Potential Monitoring Biomarkers in COVID-19: A New Hope. JRMC [Internet]. 30Mar.2021 [cited 5Aug.2021];25(1):134-9. Available from: https://journalrmc.com/index.php/JRMC/article/view/1580