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Immature Platelets as a Biomarker for Disease Severity and Mortality in COVID-19 Patients

D. Welder1, H. Jeon-Slaughter1, B. Ashraf1, S.-H. Choi1, W. Chen1, I. Ibrahim1, T. Bat1

1University of Texas Southwestern Medical Center, Dallas, United States

Abstract Number: LPB0011

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: COVID-19, caused by SARS-CoV-2, is a contagious life-threatening viral disease that has killed more than 2.13M people worldwide. Attempts have been made to identify a biomarker to stratify disease severity to improve resource allocation. Patients with SARS-COV-2 infection manifest with higher inflammatory response and platelet hyperactivity; this raises the question of the role of thrombopoiesis in COVID-19. Immature platelet fraction (IPF%) can be used to assess bone marrow activity, thrombopoiesis.

Aims: This study investigates whether the level of thrombopoiesis associates with COVID-19 severity defined by ICU stay, ventilator use, and mortality.

Methods: A large cohort of 678 (658, 97% hospitalized) well-characterized COVID-19 patients was analyzed. This included 52.4% males, 38.9% White, 26.8% Black, 25.2% Hispanic, 2.5% Asian/AI/PI, and 6.5% Other. Overall age was 61.5±16.7 years. Other characteristics reviewed included smoking status, comorbidities, and steroid use at the time of admission. Additionally, 5.6% (n=38) had thrombosis during admission. Group differences in continuous and categorical variables were tested using Two-sided Wilcoxon rank sum test and Mantel Chi-Square statistics, respectively.

Results: Elevated IPF% at presentation was predictive of length of hospitalization (p<0.01). Additionally, peak values of IPF% were significantly higher among deceased patients compared to recovered patients (7.9±6.3 vs 5.4±7.8, p<0.01). Approximately 20% of hospitalized patients were admitted to the intensive care unit (ICU) with an average length of stay 11±12 days; these had significantly higher IPF% at presentation compared to those who did not require ICU care (5.8±4.6 vs 4.7±2.6, p<0.01).

Baseline characteristics, IPF (%), and platelet counts of the study cohort (n=678)

Logistic regression results of IPF% on death, ICU, and Ventilator outcomes Note: 95% confidence interval (lower CL-upper CL) of Odds Ratios (OR) does not include ‘1’ is statistically significant under α = 0.05.

Conclusions: Higher IPF%, as a biomarker of thrombopoiesis, can predict disease severity, length of stay, and mortality risk among hospitalized COVID-19 patients.

To cite this abstract in AMA style:

Welder D, Jeon-Slaughter H, Ashraf B, Choi S-, Chen W, Ibrahim I, Bat T. Immature Platelets as a Biomarker for Disease Severity and Mortality in COVID-19 Patients [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/immature-platelets-as-a-biomarker-for-disease-severity-and-mortality-in-covid-19-patients/. Accessed August 19, 2022.

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