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Immature platelets in patients hospitalized with Covid-19

Amir Cohen1, Emanuel Harari1, Michal Cipok2

  • 1Cardiology Department, Assuta Ashdod Medical Center, The Faculty of Health Sciences, Ben-Gurion University, 7 Harefua St, Ashdod, Israel.

Journal of Thrombosis and Thrombolysis
|September 30, 2020
PubMed

Insights

Coronavirus disease 2019 (Covid-19) patients show higher immature platelet counts, indicating increased platelet turnover and reactivity. These findings suggest a potential role for immature platelets in the thrombotic events associated with Covid-19.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Cardiovascular Medicine

Background:

  • Coronavirus disease 2019 (Covid-19) is linked to a high incidence of thromboembolic events.
  • Currently, no reliable biomarkers guide antithrombotic therapy in Covid-19 patients.
  • Immature platelets are recognized as a hyper-reactive platelet subset associated with arterial thrombotic events.

Purpose of the Study:

  • To investigate and compare immature platelet indices in Covid-19 patients versus those with acute myocardial infarction (AMI) and stable cardiovascular risk factors.
  • To assess the potential of immature platelet fraction (IPF) and immature platelet count (IPC) as indicators of thrombotic risk in Covid-19.

Main Methods:

  • A prospective study comparing Covid-19 patients (n=47) with AMI patients (n=100) and a stable cardiovascular risk factor group (n=64).
  • Measurement of IPF and IPC using the Sysmex XN-3000 auto-analyzer on admission and at follow-up time-points.
  • Statistical analysis to compare IPF and IPC values between the groups.

Main Results:

  • Admission IPF% and IPC were significantly higher in Covid-19 patients compared to the stable group, and similar to the AMI group.
  • Maximal IPF% in Covid-19 patients was higher than in the stable group and similar to the AMI group.
  • Maximal IPC was significantly elevated in Covid-19 patients compared to both stable and AMI groups, indicating increased platelet turnover during disease progression.

Conclusions:

  • Covid-19 is associated with significantly increased immature platelet indices compared to stable patients and, as the disease progresses, even compared to AMI patients.
  • The enhanced platelet turnover and reactivity observed in Covid-19 may contribute to the development of thrombotic events.
  • Immature platelet indices show promise as potential biomarkers for guiding antithrombotic therapy in Covid-19.

Keywords:
Coronavirus disease 2019Immature plateletsPlatelet aggregation inhibitorsReticulated plateletsSARS-CoV-2 infectionThrombosis

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