Georgiadou Despoina, Xanthos Theodoros, Komninaka Veroniki, Xatzikiriakou Rea, Baka Stavroula, Pouliakis Abraham, Spyridaki Aikaterini, Theodoridis Dimitrios, Papapanagiotou Angeliki, Karida Afroditi, Paliatsiou Styliani, Volaki Paraskevi, Barmparousi Despoina, Sakagianni Aikaterini, Tsagarakis Nikolaos J, Alexandridou Maria, Palla Eleftheria, Kanakaris Christos, Iacovidou Nicoletta M
Hematology Department, Sismanoglio-A. Flemig, General Hospital of Attica, 15127 Athens, Greece.
School of Health Sciences, University of West Attica, 12243 Athens, Greece.
J Clin Med. 2025 Jul 30;14(15):5381. doi: 10.3390/jcm14155381.
: COVID-19-associated coagulopathy (CAC) is a complex condition, with high rates of thrombosis, high levels of inflammation markers and hypercoagulation (increased levels of fibrinogen and D-Dimer), as well as extensive microthrombosis in the lungs and other organs of the deceased. It resembles, without being identical, other coagulation disorders such as sepsis-DIC (SIC/DIC), hemophagocyte syndrome (HPS) and thrombotic microangiopathy (TMA). Platelets (PLTs), key regulators of thrombosis, inflammation and immunity, are considered an important risk mediator in COVID-19 pathogenesis. Platelet index MPV/PLT ratio is reported in the literature as more specific in the prognosis of platelet-related systemic thrombogenicity. Studies of MPV/PLT ratio with regards to the severity of COVID-19 disease are limited, and there are no references regarding this ratio to the outcome of COVID-19 disease at specific time points of hospitalization. The aim of this study is to evaluate the relationship of COVID-19 mortality with the red cell distribution width-coefficient of variation (RDW-CV), platelets and MPV/PLT ratio parameters. : Values of these parameters in 511 COVID-19 hospitalized patients were recorded (a) on admission, (b) as mean values of the 1st and 2nd week of hospitalization, (c) over the total duration of hospitalization, (d) as nadir and zenith values, and (e) at discharge. : As for mortality (survivors vs. deceased), statistical analysis with ROC curves showed that regarding the values of the parameters on admission, only the RDW-CV baseline was of prognostic value. Platelet parameters, absolute number and MPV/PLT ratio had predictive potential for the disease outcome only as 2nd week values. On the contrary, with regards to disease severity (mild/moderate versus severe/critical), only the MPV/PLT ratio on admission can be used for prognosis, and to a moderate degree. On multivariable logistic regression analysis, only the RDW-CV mean hospitalization value (RDW-CV mean) was an independent and prognostic variable for mortality. Regarding disease severity, the MPV/PLT ratio on admission and RDW-CV mean were independent and prognostic variables. : RDW-CV, platelets and MPV/PLT ratio hematological parameters could be of predictive value for mortality and severity in COVID-19 disease, depending on the hospitalization timeline.
新型冠状病毒肺炎相关凝血病（CAC）是一种复杂病症，具有高血栓形成率、高水平炎症标志物和高凝状态（纤维蛋白原和D - 二聚体水平升高），并且在死者的肺部和其他器官存在广泛的微血栓形成。它与其他凝血障碍，如脓毒症 - 弥散性血管内凝血（SIC/DIC）、噬血细胞综合征（HPS）和血栓性微血管病（TMA）相似但并不相同。血小板（PLTs）是血栓形成、炎症和免疫的关键调节因子，被认为是新型冠状病毒肺炎发病机制中的重要风险介质。文献报道血小板指数MPV/PLT比值在血小板相关全身血栓形成倾向的预后方面更具特异性。关于MPV/PLT比值与新型冠状病毒肺炎疾病严重程度的研究有限，且在住院的特定时间点，关于该比值与新型冠状病毒肺炎疾病结局的参考资料也没有。本研究的目的是评估新型冠状病毒肺炎死亡率与红细胞分布宽度变异系数（RDW - CV）、血小板及MPV/PLT比值参数之间的关系。：记录了511例新型冠状病毒肺炎住院患者这些参数的值（a）入院时，（b）住院第1周和第2周的平均值，（c）住院总时长期间，（d）最低点和最高点值，以及（e）出院时。：至于死亡率（幸存者与死者），采用ROC曲线进行的统计分析表明，就入院时参数值而言，只有RDW - CV基线具有预后价值。血小板参数、绝对数量和MPV/PLT比值仅作为第2周的值对疾病结局具有预测潜力。相反，就疾病严重程度（轻度/中度与重度/危重度）而言，只有入院时的MPV/PLT比值可用于预后，且程度适中。在多变量逻辑回归分析中，只有住院期间RDW - CV平均值（RDW - CV mean）是死亡率的独立预后变量。关于疾病严重程度，入院时的MPV/PLT比值和RDW - CV平均值是独立预后变量。：RDW - CV、血小板及MPV/PLT比值血液学参数可能对新型冠状病毒肺炎疾病的死亡率和严重程度具有预测价值，这取决于住院时间线。
