Elsevier

Clinica Chimica Acta

Volume 506, July 2020, Pages 145-148
Clinica Chimica Acta

Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis

https://doi.org/10.1016/j.cca.2020.03.022Get rights and content

Highlights

  • Platelet count can discriminate between severe and non-severe COVID-19 infections.

  • Patients who did not survive have a significantly lower platelet count than survivors.

  • Thrombocytopenia is associated with increased risk of severe disease.

  • A substantial decrease in platelet count may be an indicator of worsening illness.

Abstract

Background

Coronavirus disease 2019 (COVID-19) is a novel infectious disease with lack of established laboratory markers available to evaluate illness severity. In this study, we investigate whether platelet count could differentiate between COVID-19 patients with or without severe disease. Additionally, we evaluate if thrombocytopenia is associated with severe COVID-19.

Methods

An electronic search in Medline, Scopus and Web of Science was performed to identify studies reporting data on platelet count in COVID-19 patients. A meta-analysis was performed, with calculation of weighted mean difference (WMD) of platelet number in COVID-19 patients with or without severe disease and odds ratio (OR) of thrombocytopenia for severe form of COVID-19.

Results

Nine studies with 1779 COVID-19 patients, 399 (22.4%) with severe disease, were included in the meta-analysis. The pooled analysis revealed that platelet count was significantly lower in patients with more severe COVID-19 (WMD −31 × 109/L; 95% CI, from −35 to −29 × 109/L). A subgroup analysis comparing patients by survival, found an even lower platelet count was observed with mortality (WMD, −48 × 109/L; 95% CI, −57 to −39 × 109/L. In the four studies (n = 1427) which reported data on rate of thrombocytopenia, a low platelet count was associated with over fivefold enhanced risk of severe COVID-19 (OR, 5.1; 95% CI, 1.8–14.6).

Conclusions

Low platelet count is associated with increased risk of severe disease and mortality in patients with COVID-19, and thus should serve as clinical indicator of worsening illness during hospitalization.

Keywords

Platelets
Thrombocytopenia
Coronavirus, COVID-19

Cited by (0)

1

These authors share senior authorship in this work.

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