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Publications

Journal Article Epublish

PubMed: 40807003 DOI: 10.3390/jcm14155381

Red Cell Distribution Width (RDW), Platelets and Platelet Index MPV/PLT Ratio as Specific Time Point Predictive Variables of Survival Outcomes in COVID-19 Hospitalized Patients.

J Clin Med 14(15)

Authors: Despoina Georgiadou, Theodoros Xanthos, Veroniki Komninaka, Rea Xatzikiriakou, Stavroula Baka, Abraham Pouliakis, Aikaterini Spyridaki, Dimitrios Theodoridis, Angeliki Papapanagiotou, Afroditi Karida, Styliani Paliatsiou, Paraskevi Volaki, Despoina Barmparousi, Aikaterini Sakagianni, Nikolaos J Tsagarakis, Maria Alexandridou, Eleftheria Palla, Christos Kanakaris, Nicoletta M Iacovidou

Affiliations

  • Hematology Department, Sismanoglio-A. Flemig, General Hospital of Attica, 15127 Athens, Greece.
  • School of Health Sciences, University of West Attica, 12243 Athens, Greece.
  • Hematology Laboratory, G. Gennimatas, General Hospital of Attica, 11527 Athens, Greece.
  • Hematology Laboratory, Sismanoglio, General Hospital of Attica, 15126 Athens, Greece.
  • Medical School, National Kapodistrian University of Athens, 11528 Athens, Greece.
  • 2nd Department of Pathology, "Attikon" Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
  • Internal Medicine Department, Sismanoglio-A. Flemig, General Hospital of Attica, 15127 Athens, Greece.
  • Hematology and Biochemistry Department, Konstantopouleio-Patision Hospital, 14233 Athens, Greece.
  • Hematological & Biochemical Department, Laiko Hospital, 11527 Athens, Greece.
  • Hematology Laboratory, Evaggelismos Hospital, 10676 Athens, Greece.
  • 2nd Department of Obstetrics & Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
  • Department of Neonatology, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
  • Haematology Laboratory, Alexandra Hospital, 11528 Athens, Greece.
  • Intensive Care Unit, Sismanoglio General Hospital of Attica, 15126 Athens, Greece.

Abstract

Background: COVID-19-associated coagulopathy (CAC) is a complex condition, with high rates of thrombosis, high levels of inflammation markers and hypercoagulation (increased levels of fibrinogen and D-Dimer), as well as extensive microthrombosis in the lungs and other organs of the deceased. It resembles, without being identical, other coagulation disorders such as sepsis-DIC (SIC/DIC), hemophagocyte syndrome (HPS) and thrombotic microangiopathy (TMA). Platelets (PLTs), key regulators of thrombosis, inflammation and immunity, are considered an important risk mediator in COVID-19 pathogenesis. Platelet index MPV/PLT ratio is reported in the literature as more specific in the prognosis of platelet-related systemic thrombogenicity. Studies of MPV/PLT ratio with regards to the severity of COVID-19 disease are limited, and there are no references regarding this ratio to the outcome of COVID-19 disease at specific time points of hospitalization. The aim of this study is to evaluate the relationship of COVID-19 mortality with the red cell distribution width-coefficient of variation (RDW-CV), platelets and MPV/PLT ratio parameters. Methods: Values of these parameters in 511 COVID-19 hospitalized patients were recorded (a) on admission, (b) as mean values of the 1st and 2nd week of hospitalization, (c) over the total duration of hospitalization, (d) as nadir and zenith values, and (e) at discharge. Results: As for mortality (survivors vs. deceased), statistical analysis with ROC curves showed that regarding the values of the parameters on admission, only the RDW-CV baseline was of prognostic value. Platelet parameters, absolute number and MPV/PLT ratio had predictive potential for the disease outcome only as 2nd week values. On the contrary, with regards to disease severity (mild/moderate versus severe/critical), only the MPV/PLT ratio on admission can be used for prognosis, and to a moderate degree. On multivariable logistic regression analysis, only the RDW-CV mean hospitalization value (RDW-CV mean) was an independent and prognostic variable for mortality. Regarding disease severity, the MPV/PLT ratio on admission and RDW-CV mean were independent and prognostic variables. Conclusions: RDW-CV, platelets and MPV/PLT ratio hematological parameters could be of predictive value for mortality and severity in COVID-19 disease, depending on the hospitalization timeline.

MeSH

Cells, Mortality, Hospitalization, Dacarbazine, Covid-19, Thrombosis, Blood Platelets, Prognosis