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Longitudinal multiparametric characterization of platelet dysfunction in COVID-19: Effects of disease severity, anticoagulation therapy and inflammatory statusстатья
Статья опубликована в высокорейтинговом журнале
Информация о цитировании статьи получена из
Scopus
Статья опубликована в журнале из списка Web of Science и/или Scopus
Дата последнего поиска статьи во внешних источниках: 8 апреля 2022 г.
- Авторы: Martyanov Alexey A., Boldova Anna E., Stepanyan Maria G., An Olga I., Gur'eev Alexander S., Kassina Darya V., Volkov Alexey Y., Balatskiy Alexandr V., Butylin Andrei A., Karamzin Sergei S., Filimonova Elena V., Tsarenko Sergei V., Roumiantsev Sergei A., Rumyantsev Alexander G., Panteleev Mikhail A., Ataullakhanov Fazoil I., Sveshnikova Anastasia N.
- Журнал: Thrombosis Research
- Том: 211
- Год издания: 2022
- Издательство: Pergamon Press
- Местоположение издательства: United States
- Первая страница: 27
- Последняя страница: 37
- DOI: 10.1016/j.thromres.2022.01.013
- Аннотация: IntroductionDefects of platelet functional responses in COVID-19 were reported, but their origin and pathophysiological significance are unclear. The objective of this study was to characterize the thrombocytopathy in COVID-19.Materials and methodsAnalysis of platelet functional responses to activation by flow cytometry and aggregometry in 46 patients with confirmed COVID-19 of different severity (non-ICU, ICU, and ECMO) over the course of hospitalization alongside with plasma coagulation, inflammatory markers (CRP, fibrinogen, NETosis assays in smears) was performed.Results and conclusionsAll patients had increased baseline percentage of procoagulant platelets (healthy: 0.9 ± 0.5%; COVID-19: 1.7 ± 0.6%). Patients had decreased agonist-induced platelet GPIb shedding (1.8 ± 0.7 vs 1.25 ± 0.4), P-Selectin exposure (1.51 ± 0.21 vs 1.1 ± 0.3) and aggregation. The values of these parameters among the non-ICU and ICU cohorts differed modestly, while the ECMO cohort differed significantly. Only ECMO patients had pronounced thrombocytopenia. While inflammatory markers improved over time, the observed platelet functional responses changed only moderately. SARS-CoV-2 RNA was found in 8% of blood samples and it did not correlate with platelet counts or responses. All patients had increased NETosis that moderately correlated with platelet dysfunction. High cumulative dosages of LMWH (average > 12,000 IU/day over 5 days) resulted in an improvement in platelet parameters. The observed pattern of platelet refractoriness was reproduced by in vitro pre-treatment of washed platelets with subnanomolar thrombin or perfusion of blood through a collagen-covered flow chamber.We conclude that platelet dysfunction in COVID-19 is consistent with the intravascular-coagulation-induced refractoriness rather than with an inflammation-induced mechanism or a direct activation by the virus.
- Добавил в систему: Свешникова Анастасия Никитична