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Is thrombocytopenia a biomarker for increased risk of severe disease in COVID-19?

Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease (COVID-19) infections: a meta-analysis. Clin Chem Acta 2020;Mar 13;506:145-8
15 April, 2020  

Research indicates that among patients in an intensive care unit, a low platelet count is independently associated with an increased risk of mortality.

In the severe acute respiratory syndrome (SARS) outbreak, it was found that thrombocytopenia occurred in up to 55% of patients and was considered as a significant mortality risk factor.

Whether or not thrombocytopenia was also a predictor of more severe disease severity in COVID-19 was the subject of a recent meta-analysis.

In a recent paper published in Clin Chem Acta, Lippi and colleagues identified a total of nine studies that included 1779 patients with COVID-19 infection and 399 with severe disease were included in the analysis.

In seven of these studies, patients with more severe disease displayed a lower platelet count compared with those with mild disease, although in two of the studies, the platelet count was lower in those with less severe disease.

Overall, the authors reported that thrombocytopenia was associated with a threefold enhanced risk of severe COVID-19. The possible reasons for thrombocytopenia in those with COVID-19 remain unclear and are likely to be multifactorial.

Nevertheless, it was suggested that a patient’s platelet count might represent a simple and easily obtainable parameter for the discrimination of patients with mild and more severe disease but further work was needed to confirm these findings.