884 |
Pranata R., Lim M.A., Yonas E., Huang I., Nasution S.A., Setiati S., Alwi I., Kuswardhani R.A.T. |
57201973901;57216039756;57201987097;57208576645;57189373134;14325991900;15055173800;36863900500; |
Thrombocytopenia as a prognostic marker in COVID-19 patients: Diagnostic test accuracy meta-analysis |
2021 |
Epidemiology and Infection |
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11 |
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85100393000&doi=10.1017%2fS0950268821000236&partnerID=40&md5=d8fa1ea1b15a19b5d451c4922b96ed06 |
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia; Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia; Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia; Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia; Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah Teaching Hospital, Denpasar-Bali, Indonesia |
Pranata, R., Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia; Lim, M.A., Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia; Yonas, E., Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia; Huang, I., Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia; Nasution, S.A., Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia; Setiati, S., Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Alwi, I., Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia; Kuswardhani, R.A.T., Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah Teaching Hospital, Denpasar-Bali, Indonesia |
This systematic review and meta-analysis aimed to evaluate thrombocytopenia as a prognostic biomarker in patients with COVID-19. We performed a systematic literature search using PubMed, Embase, and EuropePMC. The main outcome was composite poor outcome, a composite of mortality, severity, need for intensive care unit care, and invasive mechanical ventilation. There were 8963 patients from 23 studies. Thrombocytopenia occurred in 18% of the patients. Male gender (p=0.037) significantly reduce the incidence. Thrombocytopenia was associated with composite poor outcome (RR 1.90 [1.43, 2.52], p<0.001; I2: 92.3%). Subgroup analysis showed that thrombocytopenia was associated with mortality (RR 2.34 [1.23, 4.45], p<0.001; I2: 96.8%) and severity (RR 1.61 [1.33, 1.96], p<0.001; I2: 62.4%). Subgroup analysis for cut-off <100 × 109/L showed RR of 1.93 [1.37, 2.72], p<0.001; I2: 83.2%). Thrombocytopenia had a sensitivity of 0.26 (0.18, 0.36), specificity of 0.89 (0.84, 0.92), positive likelihood ratio of 2.3 (1.6, 3.2), negative likelihood ratio of 0.83 (0.75, 0.93), diagnostic odds ratio of 3 (2, 4), and area under curve of 0.70 (0.66 - 0.74) for composite poor outcome. Meta-regression analysis showed that the association between thrombocytopenia and poor outcome did not vary significantly with age, male, lymphocyte, d-dimer, hypertension, diabetes, and CKD. Fagan's nomogram showed that the posterior probability of poor outcome was 50% in patients with thrombocytopenia, and 26% in those without thrombocytopenia. The Deek's funnel plot was relatively symmetrical and the quantitative asymmetry test was non-significant (p = 0.14). This study indicates that thrombocytopenia was associated with poor outcome in patients with COVID-19. © 2021 Cambridge University Press. All rights reserved. |
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aged; artificial ventilation; diagnostic test; female; human; intensive care unit; male; meta analysis; middle aged; mortality; odds ratio; pathology; prognosis; sensitivity and specificity; severity of illness index; thrombocytopenia; Aged; COVID-19; Diagnostic Tests, Routine; Female; Humans; Intensive Care Units; Male; Middle Aged; Odds Ratio; Prognosis; Respiration, Artificial; SARS-CoV-2; Sensitivity and Specificity; Severity of Illness Index; Thrombocytopenia |
Cambridge University Press |
09502688 |
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33509306 |
Article |
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992 |
4419 |
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