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Platelet Indices and Platelet to Lymphocyte Ratio (PLR) as Markers for Predicting COVID-19 Infection Severity
Rahul Ravindra1, Prakriti Ramamurthy1, Shaikh Mohammed Aslam S2
1Internal Medicine, Ramaiah Medical College, Bengaluru, IND.
Insights
The platelet lymphocyte ratio (PLR) effectively predicts COVID-19 severity and mortality. This marker showed significant differences between mild and severe coronavirus disease 2019 cases and between survivors and non-survivors.
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has led to a global health crisis.
- Predictive markers for COVID-19 severity and mortality are crucial for patient management.
- Platelet indices, including platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and platelet lymphocyte ratio (PLR), are being investigated as potential biomarkers.
Purpose of the Study:
- To evaluate the utility of platelet count, MPV, PDW, and PLR as markers for predicting COVID-19 severity.
- To assess the association of these platelet parameters with mortality in COVID-19 patients.
Main Methods:
- Retrospective study at an Indian tertiary care center (April-June 2021).
- Included 100 patients admitted with COVID-19, categorized into mild and severe groups.
- Analyzed platelet count, MPV, PDW, and PLR at admission, correlating them with disease severity and mortality using independent t-tests and ROC curves.
Main Results:
- A statistically significant difference in mean PLR was observed between mild (141.40) and severe (252.6) COVID-19 groups (P<0.001).
- Mean PLR was significantly higher in non-survivors (302.78) compared to survivors (104.4) (P<0.001).
- No significant differences were found for platelet count, MPV, or PDW between severity groups or survival outcomes.
Conclusions:
- Platelet lymphocyte ratio (PLR) is a reliable and significant marker for assessing COVID-19 severity.
- PLR demonstrates strong predictive value for mortality in patients with coronavirus disease 2019.
- Platelet count, MPV, and PDW were not found to be significant predictors in this study cohort.
Abstract:
Background Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (or coronavirus disease 2019; COVID-19) has caused a large number of infections across the globe. Numerous markers are being used to predict the severity of infection. This study was undertaken to assess the utility of platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and platelet lymphocyte ratio (PLR) as markers of severity and mortality among patients with COVID-19 infection. Methodology This is a retrospective study conducted in a tertiary care center in India from April 2021 to June 2021. Patients admitted with COVID-19 infection were included in the study. Based on the severity, patients were categorized into the mild and severe (moderate severity included) groups. Platelet count, MPV, PDW, and PLR done at admission were studied and correlated with the disease severity and mortality. Statistics The independent t-test was used to compare the variables. The receiver operating characteristic (ROC) curve was done to identify the cut-off value. Statistical analysis was performed using SPSS 18 software (SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc). Results One hundred patients admitted with COVID-19 infection were studied. 51 patients had a mild and 49 had a severe infection. The mean PLR was 141.40 among patients with mild illness and 252.6 with severe infection (P<0.001). The mean PLR among survivors was 104.4 (SD-23.56) and among nonsurvivors was 302.78 (SD-34.5) (P<0.001). There was no statistically significant difference between the two groups with respect to platelet count, MPV, and PDW. Conclusion PLR was found to be a reliable marker of severity and mortality among patients with COVID-19 illness.
