Platelet Abnormalities in Children with Laboratory-Confirmed Influenza
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Updated: Aug 9, 2025
Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
Published on: January 30, 2017
August Wrotek1,2, Oliwia Wrotek3, Teresa Jackowska1,2
1Department of Pediatrics, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland.
Insights
Platelet count abnormalities in children hospitalized with influenza indicate a higher risk of complications and a more severe disease course. These findings suggest platelet parameters can aid in assessing pediatric influenza severity.
Area of Science:
- Hematology
- Pediatrics
- Infectious Diseases
Background:
- Platelets play a role in immune responses.
- Platelet parameter abnormalities (PLT, MPV) may have diagnostic/prognostic value in influenza.
Purpose of the Study:
- To analyze the prognostic value of platelet parameters in children hospitalized with laboratory-confirmed influenza.
Main Methods:
- Retrospective analysis of platelet parameters (PLT, MPV, MPV/PLT, PLT/lymphocyte ratio).
- Correlation with influenza complications (acute otitis media, pneumonia, LRTI) and clinical course (antibiotic treatment, transfer, death).
Main Results:
- Abnormal PLT observed in 17.2% of cases, correlating with increased odds of complications (OR=1.67), including LRTI (OR=1.89).
- Thrombocytosis linked to LRTI and pneumonia, especially in infants. Thrombocytopaenia associated with antibiotic use and longer hospital stays.
- MPV/PLT ratio showed versatility in predicting LRTI, pneumonia, and antibiotic treatment across different age groups.
Conclusions:
- Platelet parameters (PLT count, MPV/PLT ratio) correlate with increased complications and severity in pediatric influenza.
- These parameters may assist in assessing pediatric influenza patients but require cautious interpretation due to age-specific variations.
Background:
The role of platelets in the immune response against influenza has been raised, and a diagnostic or prognostic value of platelet parameter abnormalities, including platelet count (PLT), or mean platelet volume (MPV), has been suggested. The study aimed to analyze the prognostic value of platelet parameters in children hospitalized due to laboratory-confirmed influenza.
Methods:
We retrospectively verified the platelet parameters (PLT, MPV, MPV/PLT, and PLT/lymphocyte ratio regarding the influenza complications (acute otitis media, pneumonia, and lower respiratory tract infection-LRTI), and the clinical course (antibiotic treatment, tertiary care transfer, and death).
Results:
An abnormal PLT was observed in 84 out of 489 laboratory-confirmed cases (17.2%, 44 thrombocytopaenia cases, and 40 thrombocytoses). Patients' age correlated negatively with PLT (rho = -0.46) and positively with MPV/PLT (rho = 0.44), while MPV was not age-dependent. The abnormal PLT correlated with increased odds of complications (OR = 1.67), including LRTI (OR = 1.89). Thrombocytosis was related to increased odds of LRTI (OR = 3.64), and radiologically/ultrasound-confirmed pneumonia (OR = 2.15), mostly in children aged under 1 year (OR = 4.22 and OR = 3.79, respectively). Thrombocytopaenia was related to antibiotic use (OR = 2.41) and longer hospital stays (OR = 3.03). A lowered MPV predicted a tertiary care transfer (AUC = 0.77), while MPV/PLT was the most versatile parameter in predicting LRTI (AUC = 0.7 in <1 yo), pneumonia (AUC = 0.68 in <1 yo), and antibiotic treatment (AUC = 0.66 in 1-2 yo and AUC = 0.6 in 2-5 yo).
Conclusions:
Platelet parameters, including PLT count abnormalities and MPV/PLT ratio, are related to the increased odds of complications and a more severe disease course, and may add important data in assessing pediatric influenza patients, but should be interpreted cautiously due to age-related specificities.
