Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?

Objectives: In many diseases, immature platelet fraction (IPF%) is related to coagulopathy and poor outcome. This study aimed to investigate the predictive value of IPF% for the severity of pneumonia in patients with Coronavirus Disease 2019 (COVID-19). Methods: A total of 154 patients with COVID‐19 infections were included. The patients were divided into two groups according to the severity of pneumonia (severe and non severe) regarding their oxygen demand. Results: Given laboratory parameters, the median IPF% was significantly higher in the severe group (11.9 vs. 3.9%, p<0.001). Mean platelet volume (p<0.001), platelet-large cell ratio (p=0.001), platelet distribution width (p=0.001), D-Dimer (p<0.001), INR (p=0.003), and aPTT (p=0.007) were also found to be significantly higher in the severe group. Moreover, IPF (p=0.014, Odds ratio = 2.000, 95%CI: 1.149-3.482) was an independent predictor for the severity. The curve value from receiver operating characteristics was 0.879 (p<0.001, 95%CI: 0.784-0.943) for determining the severity of pneumonia. IPF% had a sensitivity and specificity value of 69.5 and 92.4% to detect the disease’s severity. Conclusions: IPF% is an independent predictor for the severity of COVID-19 pneumonia. Assessment of IPF% may both help to early determine high-risk patients with COVID-19 and to alert the physicians.

Anahtar Kelime:

İmmatür Platelet Fraksiyonu: Covid-19 Pnömonisi Olan Hastalarda Hastalık Şiddeti İçin Yeni Bir Erken Prediktif Belirteç olabilir mi?

Öz:

Amaç: Pek çok hastalıkta, immatür platelet fraksiyonu (%İPF), koagülopati ve kötü sonuçla ilişkilidir. Bu çalışma, Coronavirus Hastalığı 2019 (COVID-19) olan hastalarda pnömoni şiddeti için %İPF’nin prediktif değerini araştır mayı amaçladı. Yöntem: COVID-19 enfeksiyonu olan toplam 154 hasta dahil edildi. Hastalar, oksijen ihtiyaçları göz önüne alına rak pnömoni şiddetine göre (ağır ve ağır olmayan) iki gruba ayrıldı. Bulgular: Laboratuvar parametrelerine bakıldığında, med yan İPF yüzdesi ağır grupta anlamlı olarak daha yüksekti (% 11.9′a karşı %3.9, p<0.001). Ortalama trombosit hacmi (p<0.001), trombosit-büyük hücre oranı (p=0.001), trombosit dağılım genişliği (p=0.001), D-Dimer (p<0.001),İNR (p=0.003) ve aPTT (p=0.007) ağır grupta anlamlı olarak daha yüksek bulundu. Ayrıca, İPF (p=0.014, Odds oranı = 2.000, %95 CI: 1.149-3.482) hastalık şiddeti için bağımsız bir öngördürücü olarak bulundu. Algılayıcı işletim eğrisinden gelen eğri değeri, pnömoni şiddetini belirlemek için 0.879 (p<0.001, % 95 CI: 0.784-0.943) idi. İPF, hastalığın şiddetini saptamak için %69.5′lik duyarlılık ve %92.4′lük özgüllük değerine sahipti. Sonuç: İPF, COVID-19 pnömonisinin şiddeti için bağımsız bir öngörücüdür. %İPF’nin değerlendirilmesi, hem COVID-19′ lu yüksek riskli hastaları erken belirlemeye hem de hekimleri uyarmaya yardımcı olabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clin Chim Acta 2020;506:145–8.
2. World Health Organization. WHO coronavirus disease (COVID-19) dashboard. (Accessed 11 March 2021).
3. Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemostasis 2020;18:1421–4.
4. White D, MacDonald S, Edwards T, Bridgeman C, Hayman M, Sharp M, et al. Evaluation of COVID-19 coagulopathy; laboratory characterization using thrombin generation and nonconventional haemostasis assays. Int J Lab Hematol 2021;43:123–30.
5. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemostasis 2020;18:844–7.
6. Orf K, Rogosic S, Dexter D, Ancliff P, Badle S, Brierley J, et al. Thrombocytopenia is independently associated with poor outcome in patients hospitalized for COVID-19. Br J Haematol 2020; 190:e274–6.
7. Muronoi T, Koyama K, Nunomiya S, Lefor AK, Wada M, Koinuma T, et al. Immature platelet fraction predicts coagulopathy-related platelet consumption and mortality in patients with sepsis. Thromb Res 2016;144:169–75.
8. Lev EI. Immature platelets. Circulation 2016;134:987–8.
9. Park SH, Ha SO, Cho YU, Park CJ, Jang S, Hong SB. Immature platelet fraction in septic patients: clinical relevance of immature platelet fraction is limited to the sensitive and accurate discrimination of septic patients from non-septic patients, not to the discrimination of sepsis severity. Ann Lab Med 2016;36:1–8.
10. Briggs C, Kunka S, Hart D, Oguni S, Machin SJ. Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia. Br J Haematol 2004;126:93–9.
11. De Blasi RA, Cardelli P, Costante A, Sandri M, Mercieri M, Arcioni R. Immature platelet fraction in predicting sepsis in critically ill patients. Intensive Care Med 2013;39:636–43.
12. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708–20.
13. Sayan İ, Altınay M, Çınar AS, Türk HŞ, Peker N, Şahin K, et al. Impact of HFNC application on mortality and intensive care length of stay in acute respiratory failure secondary to COVID-19 pneumonia. Heart Lung 2021;50:425–9.
14. Yesildal F, Isman FK. High dose ascorbic acid treatment in COVID-19 patients raised some problems in clinical chemistry testing. Turk J Biochem 2020;45:491–8.
15. Khartabil TA, Russcher H, van der Ven AJAM, de Rijke YB. A summary of the diagnostic and prognostic value of hemocytometry markers in COVID-19 patients. Crit Rev Clin Lab Sci 2020;57:415–31.
16. Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID-19 severity: a literature review. Rev Med Virol 2020;31:1–10.
17. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-tolymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect 2020;81. e6–12.
18. Bal T, Dogan S, Cabalak M, Dirican E. Lymphocyte-to-C-reactive protein ratio may serve as an effective biomarker to determine COVID-19 disease severity. Turk J Biochem 2021;46:21–6.
19. Zhang Y, He L, Chen H, Lu S, Xiong Y, Liu J, et al. Manifestations of blood coagulation and its relation to clinical outcomes in severe COVID-19 patients: retrospective analysis. Int J Lab Hematol 2020;42:766–72.
20. Liu PP, Blet A, Smyth D, Li H. The science underlying COVID-19: implications for the cardiovascular system. Circulation 2020;142: 68–78.
21. Salamanna F, Maglio M, Landini MP, Fini M. Platelet functions and activities as potential hematologic parameters related to Coronavirus Disease 2019 (Covid-19). Platelets. Taylor & Francis 2020;31:627–32.
22. Li K, Wohlford-Lenane C, Perlman S, Zhao J, Jewell AK, Reznikov LR, et al. Middle east respiratory syndrome coronavirus causes multiple organ damage and lethal disease in mice transgenic for human dipeptidyl peptidase 4. J Infect Dis 2015;212:712–22.
23. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemostasis 2020;18:1469–72.
24. Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol 2020;99:1205–8.
25. Cohen A, Harari E, Cipok M, Laish-Farkash A, Bryk G, Yahud E, et al. Immature platelets in patients hospitalized with Covid-19. J Thromb Thrombolysis 2021;51:608–16.

APA	İncir S, KÖMEŞLİ Z, Baygül A, Atam Taşdemir Z, PALOĞLU K, KANT H, Kapmaz M, TEKİN S, Kilic A, DAĞEL T, OKAN A, Somay K, Akpinar T (2021). Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. , 359 - 366. 10.1515/tjb-2021-0070
Chicago	İncir Said,KÖMEŞLİ Zeynep,Baygül Arzu,Atam Taşdemir Zeynep,PALOĞLU Kerim Erhan,KANT Hatice,Kapmaz Mahir,TEKİN Suda,Kilic Alparslan,DAĞEL Tuncay,OKAN Ayşe,Somay Kayra,Akpinar Timur Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. (2021): 359 - 366. 10.1515/tjb-2021-0070
MLA	İncir Said,KÖMEŞLİ Zeynep,Baygül Arzu,Atam Taşdemir Zeynep,PALOĞLU Kerim Erhan,KANT Hatice,Kapmaz Mahir,TEKİN Suda,Kilic Alparslan,DAĞEL Tuncay,OKAN Ayşe,Somay Kayra,Akpinar Timur Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. , 2021, ss.359 - 366. 10.1515/tjb-2021-0070
AMA	İncir S,KÖMEŞLİ Z,Baygül A,Atam Taşdemir Z,PALOĞLU K,KANT H,Kapmaz M,TEKİN S,Kilic A,DAĞEL T,OKAN A,Somay K,Akpinar T Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. . 2021; 359 - 366. 10.1515/tjb-2021-0070
Vancouver	İncir S,KÖMEŞLİ Z,Baygül A,Atam Taşdemir Z,PALOĞLU K,KANT H,Kapmaz M,TEKİN S,Kilic A,DAĞEL T,OKAN A,Somay K,Akpinar T Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. . 2021; 359 - 366. 10.1515/tjb-2021-0070
IEEE	İncir S,KÖMEŞLİ Z,Baygül A,Atam Taşdemir Z,PALOĞLU K,KANT H,Kapmaz M,TEKİN S,Kilic A,DAĞEL T,OKAN A,Somay K,Akpinar T "Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?." , ss.359 - 366, 2021. 10.1515/tjb-2021-0070
ISNAD	İncir, Said vd. "Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?". (2021), 359-366. https://doi.org/10.1515/tjb-2021-0070

APA	İncir S, KÖMEŞLİ Z, Baygül A, Atam Taşdemir Z, PALOĞLU K, KANT H, Kapmaz M, TEKİN S, Kilic A, DAĞEL T, OKAN A, Somay K, Akpinar T (2021). Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. Türk Biyokimya Dergisi, 46(4), 359 - 366. 10.1515/tjb-2021-0070
Chicago	İncir Said,KÖMEŞLİ Zeynep,Baygül Arzu,Atam Taşdemir Zeynep,PALOĞLU Kerim Erhan,KANT Hatice,Kapmaz Mahir,TEKİN Suda,Kilic Alparslan,DAĞEL Tuncay,OKAN Ayşe,Somay Kayra,Akpinar Timur Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. Türk Biyokimya Dergisi 46, no.4 (2021): 359 - 366. 10.1515/tjb-2021-0070
MLA	İncir Said,KÖMEŞLİ Zeynep,Baygül Arzu,Atam Taşdemir Zeynep,PALOĞLU Kerim Erhan,KANT Hatice,Kapmaz Mahir,TEKİN Suda,Kilic Alparslan,DAĞEL Tuncay,OKAN Ayşe,Somay Kayra,Akpinar Timur Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. Türk Biyokimya Dergisi, vol.46, no.4, 2021, ss.359 - 366. 10.1515/tjb-2021-0070
AMA	İncir S,KÖMEŞLİ Z,Baygül A,Atam Taşdemir Z,PALOĞLU K,KANT H,Kapmaz M,TEKİN S,Kilic A,DAĞEL T,OKAN A,Somay K,Akpinar T Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. Türk Biyokimya Dergisi. 2021; 46(4): 359 - 366. 10.1515/tjb-2021-0070
Vancouver	İncir S,KÖMEŞLİ Z,Baygül A,Atam Taşdemir Z,PALOĞLU K,KANT H,Kapmaz M,TEKİN S,Kilic A,DAĞEL T,OKAN A,Somay K,Akpinar T Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?. Türk Biyokimya Dergisi. 2021; 46(4): 359 - 366. 10.1515/tjb-2021-0070
IEEE	İncir S,KÖMEŞLİ Z,Baygül A,Atam Taşdemir Z,PALOĞLU K,KANT H,Kapmaz M,TEKİN S,Kilic A,DAĞEL T,OKAN A,Somay K,Akpinar T "Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?." Türk Biyokimya Dergisi, 46, ss.359 - 366, 2021. 10.1515/tjb-2021-0070
ISNAD	İncir, Said vd. "Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?". Türk Biyokimya Dergisi 46/4 (2021), 359-366. https://doi.org/10.1515/tjb-2021-0070