Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis
Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis
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DOI：
10.1016/j.cca.2020.03.022
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发表时间：
2020-07-01
影响因子：
5
通讯作者：
Henry, Brandon Michael
中科院分区：
文献类型：
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作者：
Lippi, Giuseppe;Plebani, Mario;Henry, Brandon Michael
背景资料：2019冠状病毒病（COVID-19）是一种新型传染病，缺乏可用于评估疾病严重程度的既定实验室标志物。在这项研究中，我们调查了血小板计数是否可以区分有或没有严重疾病的COVID-19患者。此外，我们评估血小板减少症是否与严重的COVID-19相关。方法：在Medline，Scopus和Web of Science中进行电子检索，以确定报告COVID-19患者血小板计数数据的研究。采用Meta分析方法，计算有无重症患者血小板计数的加权均值差（WMD）和重症患者血小板减少的比值比（OR）。结果：共纳入9篇研究，共纳入1779例患者，其中重症患者399例（22.4%）。汇总分析显示，在COVID-19更严重的患者中，血小板计数显著较低（WMD为-31 x 10（9）/L; 95% CI为-35至-29 x 10（9）/L）。一项亚组分析比较了患者的生存率，发现死亡率（WMD，- 48 x 10（9）/L; 95% CI，- 57至- 39 x 10（9）/L）的血小板计数甚至更低。在这四项研究中，（n = 1427）报告了血小板减少症发生率的数据，低血小板计数与严重COVID-19风险增加5倍以上相关（OR，5.1; 95%CI，1.8-14.6）。血小板计数低与COVID-19患者重症和死亡风险增加相关，因此应该作为住院期间病情恶化的临床指标。
Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease with lack of established laboratory markers available to evaluate illness severity. In this study, we investigate whether platelet count could differentiate between COVID-19 patients with or without severe disease. Additionally, we evaluate if thrombocytopenia is associated with severe COVID-19.Methods: An electronic search in Medline, Scopus and Web of Science was performed to identify studies reporting data on platelet count in COVID-19 patients. A meta-analysis was performed, with calculation of weighted mean difference (WMD) of platelet number in COVID-19 patients with or without severe disease and odds ratio (OR) of thrombocytopenia for severe form of COVID-19.Results: Nine studies with 1779 COVID-19 patients, 399 (22.4%) with severe disease, were included in the meta-analysis. The pooled analysis revealed that platelet count was significantly lower in patients with more severe COVID-19 (WMD -31 x 10(9)/L; 95% CI, from -35 to -29 x 10(9)/L). A subgroup analysis comparing patients by survival, found an even lower platelet count was observed with mortality (WMD, - 48 x 10(9)/L; 95% CI, - 57 to - 39 x 10(9)/L. In the four studies (n = 1427) which reported data on rate of thrombocytopenia, a low platelet count was associated with over fivefold enhanced risk of severe COVID-19 (OR, 5.1; 95% CI, 1.8-14.6).Conclusions: Low platelet count is associated with increased risk of severe disease and mortality in patients with COVID-19, and thus should serve as clinical indicator of worsening illness during hospitalization.