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Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients
BACKGROUND: Thrombocytopenia 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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
PeerJ Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9250762/ https://www.ncbi.nlm.nih.gov/pubmed/35791362 http://dx.doi.org/10.7717/peerj.13608 |
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author | Yuan, Yang Wang, Gang Chen, Xi Ye, Xiao-Lei Li, Xiao-Kun Li, Rui Jiang, Wan-Li Zeng, Hao-Long Du, Juan Zhang, Xiao-Ai Li, Hao Fang, Li-Qun Lu, Qing-Bin Liu, Wei |
author_facet | Yuan, Yang Wang, Gang Chen, Xi Ye, Xiao-Lei Li, Xiao-Kun Li, Rui Jiang, Wan-Li Zeng, Hao-Long Du, Juan Zhang, Xiao-Ai Li, Hao Fang, Li-Qun Lu, Qing-Bin Liu, Wei |
author_sort | Yuan, Yang |
collection | PubMed |
description | BACKGROUND: Thrombocytopenia 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. METHODS: To 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. RESULTS: Thrombocytopenia 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. CONCLUSIONS: Our 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. |
format | Online Article Text |
id | pubmed-9250762 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | PeerJ Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92507622022-07-04 Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients Yuan, Yang Wang, Gang Chen, Xi Ye, Xiao-Lei Li, Xiao-Kun Li, Rui Jiang, Wan-Li Zeng, Hao-Long Du, Juan Zhang, Xiao-Ai Li, Hao Fang, Li-Qun Lu, Qing-Bin Liu, Wei PeerJ Epidemiology BACKGROUND: Thrombocytopenia 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. METHODS: To 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. RESULTS: Thrombocytopenia 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. CONCLUSIONS: Our 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. PeerJ Inc. 2022-06-30 /pmc/articles/PMC9250762/ /pubmed/35791362 http://dx.doi.org/10.7717/peerj.13608 Text en ©2022 Yuan et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited. |
spellingShingle | Epidemiology Yuan, Yang Wang, Gang Chen, Xi Ye, Xiao-Lei Li, Xiao-Kun Li, Rui Jiang, Wan-Li Zeng, Hao-Long Du, Juan Zhang, Xiao-Ai Li, Hao Fang, Li-Qun Lu, Qing-Bin Liu, Wei Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients |
title | Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients |
title_full | Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients |
title_fullStr | Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients |
title_full_unstemmed | Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients |
title_short | Thrombocytopenia and increased risk of adverse outcome in COVID-19 patients |
title_sort | thrombocytopenia and increased risk of adverse outcome in covid-19 patients |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9250762/ https://www.ncbi.nlm.nih.gov/pubmed/35791362 http://dx.doi.org/10.7717/peerj.13608 |
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