Platelet-Based Biomarkers for Diagnosis and Prognosis in COVID-19 Patients

• Published in: Life (Basel, Switzerland) Switzerland), 2021-09, Vol.11 (10), p.1005
• Main Authors: Alberca, Ricardo Wesley, Solis-Castro, Rosa Liliana, Solis-Castro, Maria Edith, Cardoso, Fernanda, Duarte, Alberto Jose da Silva, Oliveira, Luana de Mendonça, Pereira, Nátalli Zanete, Gozzi-Silva, Sarah Cristina, Oliveira, Emily Araujo de, Aoki, Valeria, Orfali, Raquel Leao, Beserra, Danielle Rosa, Andrade, Milena Mary de Souza, Sato, Maria Notomi
• Format: Article
• Language: English
• Subjects: Biomarkers; C-reactive protein; Coagulation; Communication; Coronaviruses; COVID-19; Creatinine; Inflammation; Laboratories; Lethality; Leukocytes (neutrophilic); Lymphocytes; Patients; platelet; Platelets; Prognosis; Respiratory diseases; SARS-CoV-2; Sepsis; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; thrombocytopenia; Urea; Viral diseases
• ISSN: 2075-1729; 2075-1729
• DOI: 10.3390/life11101005

Coronavirus disease 2019 (COVID-19) caused millions of deaths worldwide. COVID-19’s clinical manifestations range from no symptoms to a severe acute respiratory syndrome, which can result in multiple organ failure, sepsis, and death. Severe COVID-19 patients develop pulmonary and extrapulmonary infections, with a hypercoagulable state. Several inflammatory or coagulatory biomarkers are currently used with predictive values for COVID-19 severity and prognosis. In this manuscript, we investigate if a combination of coagulatory and inflammatory biomarkers could provide a better biomarker with predictive value for COVID-19 patients, being able to distinguish between patients that would develop a moderate or severe COVID-19 and predict the disease outcome. We investigated 306 patients with COVID-19, confirmed by severe acute respiratory syndrome coronavirus 2 RNA detected in the nasopharyngeal swab, and retrospectively analyzed the laboratory data from the first day of hospitalization. In our cohort, biomarkers such as neutrophil count and neutrophil-to-lymphocyte ratio from the day of hospitalization could predict if the patient would need to be transferred to the intensive care unit but failed to identify the patients´ outcomes. The ratio between platelets and inflammatory markers such as creatinine, C-reactive protein, and urea levels is associated with patient outcomes. Finally, the platelet/neutrophil-to-lymphocyte ratio on the first day of hospitalization can be used with predictive value as a novel severity and lethality biomarker in COVID-19. These new biomarkers with predictive value could be used routinely to stratify the risk in COVID-19 patients since the first day of hospitalization.