Platelet Parameters and Interleukin 6 as Predictors of Disease Severity and Outcomes Amongst Hospitalised Coronavirus Disease-19 Patients

Abstract

Introduction: COVID-19 has been declared a pandemic by the WHO. Most mortality cases were linked to the presence of cytokine storms induced by the virus. Platelet parameters and IL-6 may provide significant results in the disease severity and input in a COVID-19 patient’s management. This study aimed to determine the usefulness of platelet parameters and IL-6 with disease severity and outcomes amongst COVID-19 patients admitted to Hospital Kuala Lumpur (HKL). Methods: A retrospective study utilising clinical data of confirmed COVID-19 cases. Demographic data, platelet parameters on admission, serum IL-6 level, and treatment outcomes were retrieved and analysed. Results: 283 patients’ data were analysed. The mean age of patients was 54.10 ±14.9 years old. Sixty percent of the patients were with comorbidities and (n=65, 23%) of them had succumbed to the disease. Males and females were equally affected and (n=139, 49.1%) were Malays. Ethnicity was an independent predictor for COVID-19 severity. A significant association was found between platelet count, MPV, and IL-6 with COVID-19 severity and outcomes. PDW was not associated with disease outcomes (p=0.236). Comorbidity and platelet count were independent predictors of COVID-19 death. A multivariate analysis of patients’ platelet count, MPV, and IL-6 level using binary logistic analysis showed that platelet count of the non-survivor group significantly decreased by 0.004, compared to the survivor group. Conclusion: Combining a readily available routine blood investigation of low platelet count, raised MPV, and IL-6 level signifies an increased risk of COVID-19 severity, and thus, warrants close clinical attention in reducing mortality.