AUTHOR=Siniscalchi Carmine , Di Micco Pierpaolo , Guerra Angela , Simoni Riccardo , Magro Julia , Parise Alberto , Cerundolo Nicoletta , Imbalzano Egidio , Tana Claudio , Finardi Lorenzo , Meschi Tiziana 

TITLE=Platelet count and clinical outcomes in hospitalized patients with COVID-19 pneumonia

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1614447

DOI=10.3389/fmed.2025.1614447

ISSN=2296-858X

ABSTRACT=BackgroundThrombocytopenia has been associated with poor outcomes in various infectious diseases, including COVID-19. This study investigates the relationship between platelet (PLT) count at hospital admission and clinical characteristics, treatments, and outcomes in patients with COVID-19 pneumonia.MethodsWe retrospectively analyzed 797 patients hospitalized for COVID-19 pneumonia, stratifying them into three groups by platelet count: <150,000/mm3 (22%), 150,000–400,000/mm3 (76%), and >400,000/mm3 (2.5%).ResultsPatients with PLT < 150,000/mm3, more frequently male, and had a higher prevalence of cirrhosis and fibrosis. They presented less severe respiratory impairment and lower inflammatory markers. They also showed lower use of enoxaparin and a higher use of fondaparinux. Mortality was at the limits of significance in this group (37% vs. 28 and 20%, p = 0.056), and thrombocytopenia was independently associated with increased risk of in-hospital death (HR 1.483, 95% CI 1.023–2.150; p = 0.037).ConclusionThrombocytopenia on admission independently predicts mortality in patients hospitalized with COVID-19 pneumonia.