Mean platelet volume in children with hepatitis A

Mean platelet volume and the association with all-cause mortality and cardiovascular mortality among incident peritoneal dialysis patients

BACKGROUND

While mean platelet volume (MPV) is linked to severity and all-cause mortality in patients with sepsis, its association with all-cause mortality and cardiovascular mortality in patients treated with peritoneal dialysis (PD) remains unknown.

OBJECTIVES

The purpose of this study was to estimate the relationship between MPV and all-cause mortality and cardiovascular mortality among patients treated with PD.

METHOD

We retrospectively collected 1322 patients treated with PD from November 1, 2005 to August 31, 2019. All-cause mortality and cardiovascular mortality was identified as the primary outcome. MPV was classified into three categories by means of X-tile software. The correlation between MPV and all-cause mortality was assessed by Cox model. Survival curves were performed by Kaplan-Meier method.

RESULTS

The median follow-up period was 50 months (30-80 months), and a total of 360 deaths were recorded. With respect to all-cause mortality, patients in MVP ≥ 10.2 fL had considerably higher risk of all-cause mortality among three models (HR 0.68, 95%CI 0.56-0.84; HR 0.70, 95%CI 0.56-0.87; HR 0.73, 95%CI 0.59-0.91; respectively). Moreover, patients treated with PD, whose MVP ≥ 10.2 fL, also suffered from significantly higher risk of cardiovascular mortality in model 1, 2, and 3 (HR 0.63, 95%CI 0.46-0.85; HR 0.66, 95%CI 0.48-0.91; HR 0.69, 95%CI 0.50-0.95; respectively).

CONCLUSIONS

This study indicates that MPV is independently correlated with both all-cause mortality and cardiovascular mortality in PD.

Clinical characteristics and laboratory parameters in differentiating dengue from other acute febrile illnesses

Background

Dengue infection is one of the most common viral infections globally, with a broad spectrum of clinical manifestations, including hemorrhage and shock. Early diagnostic confirmation of dengue infection is essential, but some areas may not have the appropriate diagnostic tools while its clinical symptoms are similar to other diseases. We aim to determine some significant clinical characteristics and laboratory parameters in differentiating dengue from other causes of febrile.

Results

This study included 527 dengue patients and 268 control patients. Multivariate analysis showed older age (OR = 12.11; 95% 5.42–26.63, p < 0.001), the absence of diarrhea (OR = 0.12; 95% CI 0.06–0.25, p < 0.001), leukopenia (OR = 13.35; 95% CI 4.99–38.71, p < 0.001), thrombocytopenia (OR = 7.12; 95% CI 2.37–21.38, p < 0.001), and normal ESR (OR = 3.03; 95% CI 1.54–5.96, p = 0.001) are significant parameters in differentiating dengue with excellence (AUC value of 0.96) and good fit of the model (p value = 0.8). The cut-off is two significant variables with a sensitivity of 91.4% and specificity of 87.5%.

Conclusions

Two or more clinical signs can help clinicians differentiate dengue from other acute febrile illnesses.

Is mean platelet volume a predictive marker for the diagnosis of COVID-19 in children?

AIM

To investigate the mean platelet volume (MPV) in asymptomatic children infected with COVID-19.

METHODS

The study included 55 children infected with COVID-19 and 60 healthy children for the comparison of leukocyte and thrombocyte count, MPV and serum C-reactive protein (CRP) levels. Demographic data and clinical findings of all the participants were recorded, including age, gender, weight, temperature, cough, shortness of breath and contact history.

RESULTS

The MPV values were determined to be statistically significantly high (P < .001) and the lymphocyte values were significantly low (p:0.002) in the asymptomatic children infected with COVID-19 compared with the healthy control children. No difference was determined between the groups in respect of CRP level, leukocyte and thrombocyte counts (P > .05). The optimal cutoff point for MPV was determined as 8.74 fl (Area under the curve-AUC:0.932) with 81.82% sensitivity and 95% specificity for the determination of children infected with COVID-19. A cutoff value of <2.12/mm³ for lymphocytes (AUC:0.670) was determined with 49.09% sensitivity and 86.67% specificity for the prediction of COVID-19. Based on the ROC analysis, the sensitivity and specificity of MPV were determined to be higher than that of lymphocyte levels.

CONCLUSION

The results of this study indicate that MPV levels are significantly high in asymptomatic children infected with COVID-19 demonstrate that this is an important predictive value and has better predictive capacity than lymphocyte values. The evaluation of MPV and lymphocyte levels together could increase diagnostic success in asymptomatic COVID-19 patients.