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Year : 2021  |  Volume : 5  |  Issue : 1  |  Page : 1

Does COVID-19 influence the platelet indices?

Faculty of Medical Laboratory Sciences, Port Sudan Ahlia College, Port Sudan, Sudan

Date of Submission25-Dec-2020
Date of Acceptance27-Dec-2020
Date of Web Publication10-Apr-2021

Correspondence Address:
Dr. Bashir Abdrhman Bashir
Faculty of Medical Laboratory Sciences, Port Sudan Ahlia College, Port Sudan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/LJMS.LJMS_108_20

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How to cite this article:
Bashir BA. Does COVID-19 influence the platelet indices?. Libyan J Med Sci 2021;5:1

How to cite this URL:
Bashir BA. Does COVID-19 influence the platelet indices?. Libyan J Med Sci [serial online] 2021 [cited 2023 Mar 30];5:1. Available from: https://www.ljmsonline.com/text.asp?2021/5/1/1/313522

More recent studies have revealed changes in platelet enumeration, function, and activity during CODVID-19.[1],[2] In this editorial, we looked to explore changes in platelet laboratory indices among COVID-19 patients. Platelet indices in the medical literature include the mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit, and platelet large cell ratio. MPV and PDW are widely and commonly utilized in clinical practice all over the world. Higher MPV and PDW were found in sepsis, and PDW was proved to be a bad prognostic factor in sepsis severity.[3] Nevertheless, the role of these indices in COVID-19 has not been looked into. We emphasize MPV and PDW due to their medical importance in diagnosis.

The mechanism by which platelet indices change in COVID-19 patients is likely multifactorial. Three assumptions about platelet count and structure are presented in COVID-19. First, like other coronaviruses, thrombocytopenia may be due to an infection of the bone marrow. Second, the platelet destruction by the immune system. Third, platelet consumption is caused by aggregation or clump in the lungs. Overall, platelet production increases as the number of platelets declines. A rise in the number of new platelets is also functionally more active than older platelets. This may explain the increase in platelet indexes.[4]

MPV defines the size of the platelets and is also a marker of inflammation. In the literature, although MPV levels are elevated in many diseases, they have been observed to decrease in viral diseases.[4] In the case of active inflammation, it has been described that the platelet counts increase owing to the increased inflammatory cytokine activity and that the breakdown of these larger, young platelets at the inflammation site lowers the MPV.[4] PDW denotes the platelet size distribution. A high PDW indicates destruction and, at the same time, changes in the size of newly produced immature platelets. In COVID-19, it is anticipated that the PDW will be higher as a result of platelet production and destruction processes influenced by the increased cytokine release and inflammation.[3]

A retrospective study by Ozcelik et al. found a significant decrease in the MPV in COVID-19. However, it was found that the PDW was much higher in COVID-19.[5] A further retrospective cohort study conducted by Güçlü et al. reported that MPV was significantly higher in patients with severe COVID-19 than in patients with moderate COVID-19. As well, the MPV was also significantly lower in nonsurvivors COVID-19 than in survivors COVID-19. Furthermore, PDW was much higher in nonsurvivors COVID-19 than in survivors COVID-19.[6] As documented, the MPV and PDW were found to be significantly changed in patients with COVID-19.[7] Finally, the conclusions of this editorial were evidence suggesting changes in platelet indexes (MPV and PDW) in response to COVID-19.

  References Top

Klok FA, Kruip M, van der Meer NJ, Arbous MS, Gommers D, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020;191:145-7.  Back to cited text no. 1
Thomas W, Varley J, Johnston A, Symington E, Robinson M, Sheares K, et al. Thrombotic complications of patients admitted to intensive care with COVID-19 at a teaching hospital in the United Kingdom. Thromb Res 2020;191:76-7.  Back to cited text no. 2
He J, Wei Y, Chen J, Chen F, Gao W, Lu X. Dynamic trajectory of platelet-related indicators and survival of severe COVID-19 patients. Crit Care 2020;24:607.  Back to cited text no. 3
Bashir BA. Mean platelet volume a marker for bleeding risk; a prospective study among Sudanese patients with dengue virus infection. Sudan Med J 2018;54:15-20.  Back to cited text no. 4
Ozcelik N, Ozyurt S, Yilmaz Kara B, Gumus A, Sahin U. The value of the platelet count and platelet indices in differentiation of COVID-19 and influenza pneumonia. J Med Virol 2020:1-6.  Back to cited text no. 5
Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, Yaylacı S, et al. Effect of COVID-19 on platelet count and its indices. Rev Assoc Med Bras 2020;66:1122-7.  Back to cited text no. 6
Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol 2020;99:1205-8.  Back to cited text no. 7


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