tetano
Editor, Senior Moderator
JACC Basic Transl Sci
. 2021 Feb 24.
doi: 10.1016/j.jacbts.2020.12.009. Online ahead of print.
Platelet and Endothelial Activation as Potential Mechanisms Behind the Thrombotic Complications of COVID-19 Patients
Paola Canzano[SUP] 1 [/SUP], Marta Brambilla[SUP] 1 [/SUP], Benedetta Porro[SUP] 1 [/SUP], Nicola Cosentino[SUP] 1 [/SUP], Elena Tortorici[SUP] 2 [/SUP], Stefano Vicini[SUP] 2 [/SUP], Paolo Poggio[SUP] 1 [/SUP], Andrea Cascella[SUP] 2 [/SUP], Martino F Pengo[SUP] 2 [/SUP], Fabrizio Veglia[SUP] 1 [/SUP], Susanna Fiorelli[SUP] 1 [/SUP], Alice Bonomi[SUP] 1 [/SUP], Viviana Cavalca[SUP] 1 [/SUP], Daniela Trabattoni[SUP] 1 [/SUP], Daniele Andreini[SUP] 1 [/SUP], Emanuela Omodeo Sal?[SUP] 1 [/SUP], Gianfranco Parati[SUP] 2 [/SUP], Elena Tremoli[SUP] 1 [/SUP], Marina Camera[SUP] 1 3 [/SUP]
Affiliations
Abstract
The authors hypothesized that the cytokine storm described in COVID-19 patients may lead to consistent cell-based tissue factor (TF)-mediated activation of coagulation, procoagulant microvesicles (MVs) release, and massive platelet activation. COVID-19 patients have higher levels of TF[SUP]+[/SUP] platelets, TF[SUP]+[/SUP] granulocytes, and TF[SUP]+[/SUP] MVs than healthy subjects and coronary artery disease patients. Plasma MV-associated thrombin generation is present in prophylactic anticoagulated patients. A sustained platelet activation in terms of P-selectin expression and platelet-leukocyte aggregate formation, and altered nitric oxide/prostacyclin synthesis are also observed. COVID-19 plasma, added to the blood of healthy subjects, induces platelet activation similar to that observed in vivo. This effect was blunted by pre-incubation with tocilizumab, aspirin, or a P2Y[SUB]12[/SUB] inhibitor.
Keywords: ADP, adenosine diphosphate; CAD, coronary artery disease; COVID-19; COVID-19, coronavirus disease-2019; CRP, C-reactive protein; GPA, granulocyte–platelet aggregates; HS, healthy subject; IL, interleukin; IL-6; IL-6R, interleukin-6 receptor; LMWH, low-molecular-weight heparin; MPA, monocyte–platelet aggregates; MV, microvesicle; NO, nitric oxide; NOS, nitric oxide synthase; PGI2, prostacyclin; PLA, platelet–leukocyte aggregates; PS, phosphatidylserine; SARS-CoV-2, severe acute respiratory syndrome-coronavirus-2; TF, tissue factor; antiplatelet drugs; circulating microvesicles; platelet activation; tissue factor.
. 2021 Feb 24.
doi: 10.1016/j.jacbts.2020.12.009. Online ahead of print.
Platelet and Endothelial Activation as Potential Mechanisms Behind the Thrombotic Complications of COVID-19 Patients
Paola Canzano[SUP] 1 [/SUP], Marta Brambilla[SUP] 1 [/SUP], Benedetta Porro[SUP] 1 [/SUP], Nicola Cosentino[SUP] 1 [/SUP], Elena Tortorici[SUP] 2 [/SUP], Stefano Vicini[SUP] 2 [/SUP], Paolo Poggio[SUP] 1 [/SUP], Andrea Cascella[SUP] 2 [/SUP], Martino F Pengo[SUP] 2 [/SUP], Fabrizio Veglia[SUP] 1 [/SUP], Susanna Fiorelli[SUP] 1 [/SUP], Alice Bonomi[SUP] 1 [/SUP], Viviana Cavalca[SUP] 1 [/SUP], Daniela Trabattoni[SUP] 1 [/SUP], Daniele Andreini[SUP] 1 [/SUP], Emanuela Omodeo Sal?[SUP] 1 [/SUP], Gianfranco Parati[SUP] 2 [/SUP], Elena Tremoli[SUP] 1 [/SUP], Marina Camera[SUP] 1 3 [/SUP]
Affiliations
- PMID: 33649738
- PMCID: PMC7904280
- DOI: 10.1016/j.jacbts.2020.12.009
Abstract
The authors hypothesized that the cytokine storm described in COVID-19 patients may lead to consistent cell-based tissue factor (TF)-mediated activation of coagulation, procoagulant microvesicles (MVs) release, and massive platelet activation. COVID-19 patients have higher levels of TF[SUP]+[/SUP] platelets, TF[SUP]+[/SUP] granulocytes, and TF[SUP]+[/SUP] MVs than healthy subjects and coronary artery disease patients. Plasma MV-associated thrombin generation is present in prophylactic anticoagulated patients. A sustained platelet activation in terms of P-selectin expression and platelet-leukocyte aggregate formation, and altered nitric oxide/prostacyclin synthesis are also observed. COVID-19 plasma, added to the blood of healthy subjects, induces platelet activation similar to that observed in vivo. This effect was blunted by pre-incubation with tocilizumab, aspirin, or a P2Y[SUB]12[/SUB] inhibitor.
Keywords: ADP, adenosine diphosphate; CAD, coronary artery disease; COVID-19; COVID-19, coronavirus disease-2019; CRP, C-reactive protein; GPA, granulocyte–platelet aggregates; HS, healthy subject; IL, interleukin; IL-6; IL-6R, interleukin-6 receptor; LMWH, low-molecular-weight heparin; MPA, monocyte–platelet aggregates; MV, microvesicle; NO, nitric oxide; NOS, nitric oxide synthase; PGI2, prostacyclin; PLA, platelet–leukocyte aggregates; PS, phosphatidylserine; SARS-CoV-2, severe acute respiratory syndrome-coronavirus-2; TF, tissue factor; antiplatelet drugs; circulating microvesicles; platelet activation; tissue factor.