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All Journal Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Jurnal Kesehatan Andalas Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan Majalah Kedokteran Andalas Bioscientia Medicina : Journal of Biomedicine and Translational Research Health and Medical Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Ilmu Kesehatan Indonesia (JIKSI) JIKUM: Jurnal Ilmu Komputer
Rikarni Rikarni
Department Of Clinical Pathology And Laboratory Medicine, Faculty Of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Platelet Large Cell Ratio as a Prothrombotic Biomarker to Predict the Severity of COVID-19 Rikarni, Rikarni; Najirman, Najirman; Yulia, Dwi; Burhan, Ida Rahmah; Amalina
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2622

Abstract

 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the lungs causes alveolar cell inflammation and disruption, leading to increased levels of proinflammatory cytokines that stimulate platelet activation and consumption. In response, megakaryocytes will increase the production of large, immature platelets. Large platelets bind more to fibrinogen than small platelets, increasing the potential for thrombus formation. This study aims to analyze the platelet large cell ratio as a prothrombotic biomarker to predict the severity of thrombosis in patients. A prospective cohort study was conducted in May-November 2021 at M. Djamil Hospital involving 206 samples of confirmed coronavirus disease 2019 (COVID-19) patients. The examinations included platelet count, P-LCR, and D-dimer. Large platelet counts were calculated using the Platelet Large Cell Ratio (P-LCR) parameter with an automated hematology analyzer. Clinical manifestations of disease severity were monitored based on WHO criteria, grouped into non-severe and severe disease. The 3 results showed a mean age of 47.41 (SD = 17.82). Platelet count was 263,690 (116,995)/mm , P-LCR was 30.86 (6.63)%, and D-dimer value was 2,215.97 (2,590.86) ng/mL. The P-LCR in the severe group was 35.08 (8.21)%, and the non-severe group was 26.64 (6.81)%, with p <0.001. D-dimer in the severe group was 3,680.36 (3,006.23) ng/mL, and in the non-severe group, 869.12 (977.03) ng/mL, with p <0.001. The relative risk of a high P-LCR causing severe COVID-19 is 2.35 compared to a low P-LCR, with p <0.001. The relative risk of a high D-dimer value causing severe COVID-19 is 6.80 compared to a low D-dimer, with p <0.001. The conclusion is  that a greater increase in large platelet production occurs in severe COVID-19 disease. P-LCR is a crucial biomarker for evaluating platelet activity. A high P-LCR value is a risk factor for predicting the severity of COVID-19. Suggestions for the use of PLCR. Increased risk of thrombotic events in COVID-19 patients can be identified by P-LCR examination upon admission to the hospital, allowing for preventive treatment.
Co-Authors Adi K Aman, Adi K Agri Febria Sari Agri Febria Sari Alfarizhi, Habieb Almurdi Almurdi Amalina Ananda, Gita Putri Asterina Asterina Beti E. E Dewi, Beti E. E Burhan, Ida Rahmah Chairunnisa Kusumawardhani Dedy Kurnia Defrianti, Serli Deswita Sari Desywar Desywar Dia Rofinda, Zelly Dia Dian Pertiwi Doan Atrya Dwi Yulia Dwi Yulia Efrida Efrida Elfira Yusri Ellyza Nasrul Elmatris Sy Elsa Fitriani Elvira Yusri Endrinaldi Fakhriyyatur Rahmi M Fitriani, Elsa Harika Putra Harry Isbagyo, Harry Hevrina Yufani Intan, Shinta Ayu Jesi Anggraini lillah . Malinda Meinapuri Nabila, Wulan Najirman Najirman Najirman, Najirman Niawaty, Putri Nora Harminarti Nuzirwan Acang Putri Ariani Putri Niawaty Rahajuningsih Dharma Rahmadian, Rizki Ratih Hasma Rianto Setiabudy Rika Florensia Rina Gustia Rinal Effendi Rudy Afriant Saptino Miro Selfi Renita Rusjdi Suryo Nugroho Suhardi Tambunan L Tambunan, Tambunan L Tuti Asryani Tutty Prihandani Wella Novile Izora Winanda, Mirza yoesri . Yufani, Hevrina Yulia, Dwi Yusri, Elfira Yustini Alioes Zelly Dia Rofinda