Immature Platelet Fraction: is a Novel Early Predictive Marker for Disease Severity in Patients with Covid-19 Pneumonia?

Objectives: In many diseases, immature platelet fraction (IPF%) is related to coagulopathy and poor outcome. This study aimed to investigate the predictive value of IPF% for the severity of pneumonia in patients with Coronavirus Disease 2019 (COVID-19). Methods: A total of 154 patients with COVID-19 infections were included. The patients were divided into two groups according to the severity of pneumonia (severe and nonsevere) regarding their oxygen demand. Results: Given laboratory parameters, the median IPF% was significantly higher in the severe group (11.9 vs. 3.9%, p<0.001). Mean platelet volume (p<0.001), platelet-large cell ratio (p=0.001), platelet distribution width (p=0.001), D-Dimer (p<0.001), INR (p=0.003), and aPTT (p=0.007) were also found to be significantly higher in the severe group. Moreover, IPF (p=0.014, Odds ratio = 2.000, 95%CI: 1.149-3.482) was an independent predictor for the severity. The curve value from receiver operating characteristics was 0.879 (p<0.001, 95%CI: 0.784-0.943) for determining the severity of pneumonia. IPF% had a sensitivity and specificity value of 69.5 and 92.4% to detect the disease's severity. Conclusions: IPF% is an independent predictor for the severity of COVID-19 pneumonia. Assessment of IPF% may both help to early determine high-risk patients with COVID-19 and to alert the physicians.