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+ platelets, TF+ granulocytes, and TF+ 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 invivo. This effect was blunted by pre-incubation with tocilizumab, aspirin, or a P2Y12 inhibitor.

Platelet and Endothelial Activation as Potential Mechanisms Behind the Thrombotic Complications of COVID-19 Patients / P. Canzano, M. Brambilla, B. Porro, N. Cosentino, E. Tortorici, S. Vicini, P. Poggio, A. Cascella, M.F. Pengo, F. Veglia, S. Fiorelli, A. Bonomi, V. Cavalca, D. Trabattoni, D. Andreini, E. Omodeo Salè, G. Parati, E. Tremoli, M. Camera. - In: JACC. BASIC TO TRANSLATIONAL SCIENCE. - ISSN 2452-302X. - 6:3(2021 Mar), pp. 202-218. [10.1016/j.jacbts.2020.12.009]

Platelet and Endothelial Activation as Potential Mechanisms Behind the Thrombotic Complications of COVID-19 Patients

Canzano, Paola;Porro, Benedetta;Cosentino, Nicola;Poggio, Paolo;Veglia, Fabrizio;Fiorelli, Susanna;Cavalca, Viviana;Andreini, Daniele;Tremoli, Elena;Camera, Marina
2021-03

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+ platelets, TF+ granulocytes, and TF+ 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 invivo. This effect was blunted by pre-incubation with tocilizumab, aspirin, or a P2Y12 inhibitor.
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
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Settore BIO/12 - Biochimica Clinica e Biologia Molecolare Clinica
Settore BIO/14 - Farmacologia
Settore BIO/10 - Biochimica
24-feb-2021
JACC. BASIC TO TRANSLATIONAL SCIENCE
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/822610
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