Division of Infectious Disease, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey.
Division of Pediatric Emergency, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey.
J Med Virol. 2021 May;93(5):3227-3237. doi: 10.1002/jmv.26902. Epub 2021 Mar 11.
There have been a limited number of studies on coronavirus disease 2019 (COVID-19) in children. In this study, we aimed to investigate the demographic, clinical, and laboratory features of COVID-19 and to identify the role of mean platelet volume (MPV) in predicting the prognosis in children. A single-center retrospective study, including 251 confirmed and 65 suspected COVID-19 cases, was conducted between March 11, 2020, and December 11, 2020. In the confirmed COVID-19 group, 48 (19.1%) patients were asymptomatic, 183 (72.9%) mild, 16 (6.4%) moderate, 1 (0.4%) severe, and 3 were (1.2%) critically ill. Confirmed COVID-19 patients had significantly lower mean values of white blood cell (WBC), absolute neutrophil count, absolute lymphocyte count, platelet, and hemoglobin (p < .001). However, there was no significant difference in MPV levels between the two groups (p = .894). C-reactive protein (CRP), procalcitonin, fibrinogen, and NT-pro-BNP mean values were significantly lower in confirmed COVID-19 cases than suspected cases (p < .001). A total of 55 (21.9%) patients required hospitalization due to COVID-19, and MPV, WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP were statistically higher in hospitalized patients than those in outpatients. The multivariate analysis of confirmed COVID-19 cases according to the severity of disease showed that lymphopenia and higher levels of fibrinogen significantly associated with severe clinical symptoms. Decision tree analysis showed that the most powerful predictor of hospitalization due to COVID-19 was the D-dimer (p < .001). MPV values are not associated with COVID-19 disease severity. However, MPV can be used with other parameters such as WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP to predict hospitalization.
关于 2019 年冠状病毒病(COVID-19)在儿童中的研究数量有限。在这项研究中,我们旨在研究 COVID-19 的人口统计学、临床和实验室特征,并确定平均血小板体积(MPV)在预测儿童预后中的作用。这是一项单中心回顾性研究,纳入了 2020 年 3 月 11 日至 2020 年 12 月 11 日期间确诊的 251 例和疑似的 65 例 COVID-19 病例。在确诊的 COVID-19 组中,48 例(19.1%)患者无症状,183 例(72.9%)为轻症,16 例(6.4%)为中度,1 例(0.4%)为重症,3 例(1.2%)为危重症。确诊 COVID-19 患者的白细胞(WBC)、绝对中性粒细胞计数、绝对淋巴细胞计数、血小板和血红蛋白的平均值明显较低(p <.001)。然而,两组间的 MPV 水平无显著差异(p =.894)。与疑似病例相比,确诊 COVID-19 病例的 C-反应蛋白(CRP)、降钙素原、纤维蛋白原和 NT-pro-BNP 的平均值明显较低(p <.001)。共有 55 例(21.9%)COVID-19 患者因 COVID-19 需要住院治疗,住院患者的 MPV、WBC、CRP、降钙素原、D-二聚体和 NT-pro-BNP 水平明显高于门诊患者。根据疾病严重程度对确诊 COVID-19 病例进行的多变量分析显示,淋巴细胞减少和较高的纤维蛋白原水平与严重的临床症状显著相关。决策树分析显示,导致 COVID-19 住院的最强预测因子是 D-二聚体(p <.001)。MPV 值与 COVID-19 疾病严重程度无关。然而,MPV 可与 WBC、CRP、降钙素原、D-二聚体和 NT-pro-BNP 等其他参数一起用于预测住院。