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血小板减少症及其与 COVID-19 患者死亡率的关系。

Thrombocytopenia and its association with mortality in patients with COVID-19.

机构信息

Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Research Center for Translational Medicine, Jinyintan Hospital, Wuhan, China.

出版信息

J Thromb Haemost. 2020 Jun;18(6):1469-1472. doi: 10.1111/jth.14848. Epub 2020 May 4.

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes novel coronavirus disease 2019 (COVID-19), is spreading rapidly around the world. Thrombocytopenia in patients with COVID-19 has not been fully studied.

OBJECTIVE

To describe thrombocytopenia in patients with COVID-19.

METHODS

For each of 1476 consecutive patients with COVID-19 from Jinyintan Hospital, Wuhan, China, nadir platelet count during hospitalization was retrospectively collected and categorized into (0, 50], (50, 100], (100-150], or (150-) groups after taking the unit (×10 /L) away from the report of nadir platelet count. Nadir platelet counts and in-hospital mortality were analyzed.

RESULTS

Among all patients, 238 (16.1%) patients were deceased and 306 (20.7%) had thrombocytopenia. Compared with survivors, non-survivors were older, were more likely to have thrombocytopenia, and had lower nadir platelet counts. The in-hospital mortality was 92.1%, 61.2%, 17.5%, and 4.7% for (0, 50], (50, 100], (100-150], and (150-) groups, respectively. With (150-) as the reference, nadir platelet counts of (100-150], (50, 100], and (0, 50] groups had a relative risk of 3.42 (95% confidence interval [CI] 2.36-4.96), 9.99 (95% CI 7.16-13.94), and 13.68 (95% CI 9.89-18.92), respectively.

CONCLUSIONS

Thrombocytopenia is common in patients with COVID-19, and it is associated with increased risk of in-hospital mortality. The lower the platelet count, the higher the mortality becomes.

摘要

背景

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)可引起 2019 年新型冠状病毒病(COVID-19),目前正在全球迅速传播。COVID-19 患者的血小板减少尚未得到充分研究。

目的

描述 COVID-19 患者的血小板减少症。

方法

对来自中国武汉金银潭医院的 1476 例连续 COVID-19 患者,回顾性采集住院期间血小板计数的最低值,并在去除血小板计数最低值的单位(×10 / L)后将其分为(0,50],(50,100],(100-150]或(150-)组。分析血小板计数最低值和住院死亡率。

结果

在所有患者中,有 238 例(16.1%)患者死亡,306 例(20.7%)有血小板减少症。与幸存者相比,非幸存者年龄较大,更可能发生血小板减少症,血小板计数最低值较低。(0,50],(50,100],(100-150]和(150-)组的住院死亡率分别为 92.1%,61.2%,17.5%和 4.7%。以(150-)为参照,血小板计数最低值分别为(100-150],(50,100]和(0,50]组的相对风险为 3.42(95%置信区间[CI] 2.36-4.96),9.99(95%CI 7.16-13.94)和 13.68(95%CI 9.89-18.92)。

结论

血小板减少症在 COVID-19 患者中很常见,并且与住院死亡率增加相关。血小板计数越低,死亡率越高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/368d/9906135/0e1b7fd09519/jth14848-fig-0001-m_lrg.jpg

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