1. Association of Neutrophil Activation, More Than Platelet Activation, With Thrombotic Complications in Coronavirus Disease 2019
- Author
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Petito, Eleonora, Falcinelli, Emanuela, Paliani, Ugo, Cesari, Enrica, Vaudo, Gaetano, Sebastiano, Manuela, Cerotto, Vittorio, Guglielmini, Giuseppe, Gori, Fabio, Malvestiti, Marco, Becattini, Cecilia, Paciullo, Francesco, De Robertis, Edoardo, Bury, Loredana, Lazzarini, Teseo, Gresele, Paolo, Lapenna, Maria, D’Abbondanza, Marco, Cristallini, Stefano, Franco, Laura, and Saccarelli, Luca
- Subjects
Male ,0301 basic medicine ,Neutrophils ,Low-molecular weight heparin ,030204 cardiovascular system & hematology ,Extracellular Traps ,Gastroenterology ,Neutrophil Activation ,Matrix metalloproteinase-9 (MMP-9) ,0302 clinical medicine ,80 and over ,Immunology and Allergy ,Venous thromboembolism (VTE) ,Platelet ,Aged, 80 and over ,Aspirin ,Low-Molecular-Weight ,Venous Thromboembolism ,Heparin ,Middle Aged ,Thrombosis ,AcademicSubjects/MED00290 ,Infectious Diseases ,Matrix Metalloproteinase 9 ,Neutrophil extracellular traps (NETs) ,Female ,medicine.drug ,Adult ,Blood Platelets ,medicine.medical_specialty ,medicine.drug_class ,Low molecular weight heparin ,03 medical and health sciences ,Internal medicine ,Major Article ,medicine ,Humans ,Platelet activation ,Thrombus ,Aged ,SARS-CoV-2 ,business.industry ,COVID-19 ,Neutrophil extracellular traps ,Heparin, Low-Molecular-Weight ,Platelet Activation ,medicine.disease ,030104 developmental biology ,business ,Biomarkers - Abstract
Background Severe acute respiratory syndrome coronavirus 2 infection is associated with hypercoagulability, which predisposes to venous thromboembolism (VTE). We analyzed platelet and neutrophil activation in patients with coronavirus disease 2019 (COVID-19) and their association with VTE. Methods Hospitalized patients with COVID-19 and age- and sex-matched healthy controls were studied. Platelet and leukocyte activation, neutrophil extracellular traps (NETs), and matrix metalloproteinase 9, a neutrophil-released enzyme, were measured. Four patients were restudied after recovery. The activating effect of plasma from patients with COVID-19 on control platelets and leukocytes and the inhibiting activity of common antithrombotic agents on it were studied. Results A total of 36 patients with COVID-19 and 31 healthy controls were studied; VTE developed in 8 of 36 patients with COVID-19 (22.2%). Platelets and neutrophils were activated in patients with COVID-19. NET, but not platelet activation, biomarkers correlated with disease severity and were associated with thrombosis. Plasmatic matrix metalloproteinase 9 was significantly increased in patients with COVID-19. Platelet and neutrophil activation markers, but less so NETs, normalized after recovery. In vitro, plasma from patients with COVID-19 triggered platelet and neutrophil activation and NET formation, the latter blocked by therapeutic-dose low-molecular-weight heparin, but not by aspirin or dypiridamole. Conclusions Platelet and neutrophil activation are key features of patients with COVID-19. NET biomarkers may help to predict clinical worsening and VTE and may guide low-molecular-weight heparin treatment.
- Published
- 2020
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