PLATELET DYNAMICS IN COVID-19: UNRAVELING THE CONNECTION TO ACUTE MYOCARDIAL INFARCTION
DOI:
https://doi.org/10.22551/Abstract
Aim: Inflammation is the body`s physiological defensive feedback occurring in vascularized tissues in response to damaging stimuli. The occurrence of an acute myocardial infarction is the catalyst for a massive spike in inflammatory activity throughout the system. The aim was to determine to what extent positive COVID-19 status alters the extent of this inflammatory response. Materials and methods: We retrospectively analyzed clinical and biochemical data from 54 patients with confirmed acute coronary syndrome, equally distributed for COVID-19 infection status prior to admission. Demographic parameters were mostly uniform in our study population. Results: Circulating cardiac injury markers returned a not statistically significant tendency towards higher values in COVID-19 infected subjects. Inflammation markers wise, C-reactive protein and white blood cell count were significantly higher in COVID-infected group (p < 0.05). Novel inflammatory indexes Neutrophil-and Monocyte- to HDL ratio depicted a statistically significant upward trend towards the infected individuals. Distinctly, the Neutrophil-to-Lymphocyte ratio was similar across the study population (independent 2-tailed t-test p = 0.287). Systemic immune-inflammation index (SII) returned an inverse trend compared to NHR and MHR, with statistically significant lower values for COVID-19 infected patients. SII accurately predicted in-hospital death for the whole population (AUC: 0.733; CI (0.548, 0.917)) and for COVID-19 infected group (AUC: 0.841; CI (0.685,0.998)). Conclusions: Platelet count, a component of the composite index SII, exhibited an invariable inverse trend compared to any other inflammation surrogate marker, with lower counts in the infected group regardless of adjustments. Despite the activated endothelial phenotype in the subacute phase of myocardial infarction, a pre-existing positive COVID-19 infection status is strongly associated with low platelet count values and flare-up of the immune system.
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