Critical Care and Shock

Severity of thrombocytopenia in COVID-19 patients with Epstein-Barr virus and cytomegalovirus coinfections

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Introduction: This study aimed to investigate the prevalence of viral coinfections in hospitalized patients and their potential association with platelet count (PLT) during hospitalization. Additionally, the study explored the gender and ethnic distribution of the participants, providing valuable insights into the diversity of the patient population.

Methods: Of 994 patients with coronavirus disease 2019 (COVID-19), a total of 354 patients were included in the study, with 54.8% males and 45.2% females. The ethnic distribution consisted of 52.8% Hispanic, 21.8% Caucasian, 19.5% African American, and 4.5% classified as other. Viral coinfections were analyzed during hospitalization, and groups were analyzed based on the degree of thrombocytopenia, which was classified into mild (100-150 x 103/μl), moderate (50-99 x 103/μl), and severe (<50 x 103/μl).

Results: Among the participants, 46.3% had viral coinfections during hospitalization. Active Epstein-Barr virus (EBV) coinfection was the most prevalent (18.6%), followed by active Cytomegalovirus (CMV) coinfection (2.3%), and dual EBV/CMV coinfection (3.1%). The median platelet level on admission was 149,500 (121,000-224,250) and the median lowest platelet count during hospitalization was 131,500 (85,000-188,250).

The median Acute Physiology and Chronic Health Evaluation (APACHE) II score for the total population was 11 upon admission. Notably, the median APACHE II score for severity of illness upon admission for the total population was 11, ranging from 7-18, while mild was 9 (6-14), moderate was 10 (6.5-14), and severe being associated with severity scores. While the results suggest certain trends, future research with larger and more diverse populations is needed to draw definitive conclusions.