Related Experiment Video
Updated: Sep 30, 2025
A Microfluidic Flow Chamber Model for Platelet Transfusion and Hemostasis Measures Platelet Deposition and Fibrin Formation in Real-time
Published on: February 14, 2017
Routine and Advanced Laboratory Tests for Hemostasis Disorders in COVID-19 Patients: A Prospective Cohort Study
Paul Billoir1, Perrine Leprêtre2, Caroline Thill3
1Vascular Hemostasis Unit, CHU Rouen, Normandie University, UNIROUEN, INSERM U1096, F-76000 Rouen, France.
Insights
Immature platelet count (A-IPC) can predict worsening conditions in severe COVID-19 patients admitted to the ICU. Lower A-IPC levels indicate a higher risk of poor prognosis, highlighting thrombopoiesis
Area of Science:
- Critical Care Medicine
- Hematology
- Infectious Diseases
Background:
- Thrombosis is a frequent complication in COVID-19, necessitating identification of hemostasis predictors for prognosis.
- Coagulation disorders may serve as early indicators of critical illness progression in the intensive care unit (ICU).
Purpose of the Study:
- To investigate coagulation disorders as early predictors of worsening conditions in severe COVID-19 patients.
- To utilize routine and advanced laboratory tests for predicting critical illness progression.
Main Methods:
- Collected blood samples within 24 hours of ICU admission for viscoelastic point-of-care testing (VET) and advanced assays.
- Assessed absolute immature platelet count (A-IPC), von Willebrand-GPIb activity (vWF-GpIb), prothrombin fragments 1+2 (F1+2), and thrombin generation assay (TGA).
- Analyzed associations with worsening outcomes (death or organ support) using univariable and multivariable models.
Main Results:
- Worsening patients had lower A-IPC (p=0.02) and higher fibrinogen, vWF-GpIb, and F1+2 levels.
- No significant differences were observed for D-dimer, TGA, or VET between groups.
- SAPS-II and A-IPC were independently associated with worsening (OR=1.11 and OR=0.47, respectively).
- A combination of SAPS-II ≥ 33 and A-IPC ≤ 12.6 G/L predicted worsening with 58% sensitivity and 89% specificity.
Conclusions:
- Absolute immature platelet count (A-IPC) serves as an early predictor of clinical deterioration in severe COVID-19.
- Findings suggest a significant role for thrombopoiesis in the host's response to SARS-CoV-2 infection.
Background:
Thrombosis is frequent during COVID-19 disease, and thus, identifying predictive factors of hemostasis associated with a poor prognosis is of interest. The objective was to explore coagulation disorders as early predictors of worsening critical conditions in the intensive care unit (ICU) using routine and more advanced explorations.
Materials:
Blood samples within 24 h of ICU admission for viscoelastic point-of-care testing, (VET), advanced laboratory tests: absolute immature platelet count (A-IPC), von Willebrand-GPIb activity (vWF-GpIb), prothrombin fragments 1 + 2 (F1 + 2), and the thrombin generation assay (TGA) were used. An association with worse outcomes was explored using univariable and multivariable analyses. Worsening was defined as death or the need for organ support.
Results:
An amount of 85 patients with 33 in critical condition were included. A-IPC were lower in worsening patients (9.6 [6.4-12.5] vs. 12.3 [8.3-20.7], p = 0.02) while fibrinogen (6.9 [6.1-7.7] vs. 6.2 [5.4-6.9], p = 0.03), vWF-GpIb (286 [265-389] vs. 268 [216-326], p = 0.03) and F1 + 2 (226 [151-578] vs. 155 [129-248], p = 0.01) were higher. There was no difference observed for D-dimer, TGA or VET. SAPS-II and A-IPC were independently associated with worsening (OR = 1.11 [1.06-1.17] and OR = 0.47 [0.25-0.76] respectively). The association of a SAPS-II ≥ 33 and an A-IPC ≤ 12.6 G/L predicted the worsening of patients (sensitivity 58%, specificity 89%).
Conclusions:
Immature platelets are early predictors of worsening in severe COVID-19 patients, suggesting a key role of thrombopoiesis in the adaption of an organism to SARS-CoV-2 infection.
Related Concept Videos
01:24Disorders of Hemostasis
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:05Introduction to Hemostasis
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
01:29Venous Thrombosis III: Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...