Pathophysiology (Jun 2022)

Platelet Distribution Width and Increased D-Dimer at Admission Predicts Subsequent Development of ARDS in COVID-19 Patients

  • Iviana P. Yovchevska,
  • Alexandar B. Trenovski,
  • Maria H. Atanasova,
  • Martin N. Georgiev,
  • Radka K. Tafradjiiska-Hadjiolova,
  • Simeon D. Lazarov,
  • Plamen H. Yovchevski

DOI
https://doi.org/10.3390/pathophysiology29020019
Journal volume & issue
Vol. 29, no. 2
pp. 233 – 242

Abstract

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In the current pandemic of coronavirus disease (COVID-19), the identification of the patients admitted with severe infection–who are disposed to a high risk of acute respiratory distress syndrome (ARDS) development, is of a major significance for the determination of the appropriate therapeutic strategy. Laboratory records in admission were retrospectively reviewed from 493 cases of severe COVID-19 divided into two groups: Group 1 with ARDS and Group 2 without ARDS. The platelet distribution width (PDW) difference between Group 1 and Group 2 is significant–15.10 ± 2.08 fl for those who developed ARDS versus 12.94 ± 2.12 fl for those without ARDS. The sensitivity and the specificity of this parameter is lower than that of D-dimer. After grouping of the PDW values into intervals and combining them with the rate of increase in D-dimer (D-PDWf index) to form a forecasting index, a significant increase in the specificity and sensitivity of the two parameters is identified–area under the ROC curve (AUC) is 0.874 for D-PDWf index, with respective AUC for PDW 0.768 and AUC for D-dimer 0.777. Conclusion: PDW is a significant predictive parameter at admission for subsequent development of ARDS in patients, with increased significance in combination with the degree of increase in D-dimer.

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