Русский
Estimation of the platelet component of hemostasis in COVID-19 patients
DOI: https://dx.doi.org/10.18565/therapy.2024.7.43-49
Kadnikov L.I., Izmozherova N.V., Popov A.A., Antropova I.P.
1) Ural State Medical University of the Ministry of Healthcare of Russia, Yekaterinburg; 2) Institute of High-Temperature Electrochemistry of Ural branch of the Russian Academy of Sciences, Yekaterinburg
The aim: to estimate the platelet component of hemostasis in patients with COVID-19.
Materials and methods. Case-control study included 75 patients: group 1 – with COVID-19 (n = 25), group 2 – with COVID-19 and acute coronary syndrome (ACS) (n = 25), group 3 – with ACS without COVID-19 (n = 25). Blood samples were analyzed by a Mindray BC-6800 Plus analyzer. Platelet aggregation with inducers was assessed using a ChronoLog 700 analyzer.
Results. Mean platelet volume (MPV) in group 1 was 11.0 (10.4 ÷ 11.9), in group 2 – 10.8 (10.3 ÷ 11.5), in group 3 – 10.2 (9.8 ÷ 10.7) fl (p < 0.001). Platelet distribution width (PDW) in group 1 was 13.1 (12.0 ÷ 14.5), in group 2 – 12.4 (11.7 ÷ 14.4), in group 3 – 11.9 (11.2 ÷ 12.5) % (p = 0.028), large platelet coefficient (P-LCR) – 33.5 (28.0 ÷ 39.7), 31.7 (26.8 ÷ 37.3) and 27.2 (24.7 ÷ 29.8) %, respectively (p = 0.002). Ratio of the absolute platelet count to the absolute lymphocyte count (PLR) was as follows: in group 1 – 163.4 (100.8 ÷ 237.1), in group 2 – 131.2 (103.5 ÷ 173.1), in group 3 – 113.1 (78.7 ÷ 129.5) (p = 0.019). Platelet aggregation with adenosine diphosphate in group 1 was 61.0 (56.0 ÷ 66.0), in group 2 – 48.5 (28.0 ÷ 57.0), in group 3 – 28.0 (22.0 ÷ 39.0) % (p < 0.001), platelet aggregation with collagen – 65.5 (61.5 ÷ 72.0), 57.0 (41.0 ÷ 67.5) and 54.0 (42.0 ÷ 57.0) %, respectively (p < 0.001), and platelet aggregation with epinephrine – 58.8 (53.0 ÷ 65.0), 40.0 (24.5 ÷ 55.0) and 21.0 (15.0 ÷ 30.0) %, respectively (p < 0.001).
Conclusion. Higher values of MPV, PDW, P-LCR, PLR, platelet aggregation with inducers indicate obvious activation and reactivity of platelets due to the immune-inflammatory component in individuals with COVID-19. Obtained data indicate a significant influence of SARS-CoV-2 at the functional activity of platelets.
Literature
1. Канаева Т.В., Кароли Н.А. Прогностические маркеры поражения сердечно-сосудистой системы у пациентов с COVID-19: обзор литературы. Сеченовский вестник. 2022; 13(3): 14–23. (Kanaeva T.V., Karoli N.A. Prognostic biomarkers for cardiovascular injury in patients with COVID-19: A review. Sechenovskiy vestnik = Sechenov Medical Journal. 2022; 13(3): 14–23 (In Russ.)). https://doi.org/10.47093/2218-7332.2022.13.3.14-23. EDN: BZQEIF. 2. McFadyen J.D., Stevens H., Peter K. The emerging threat of (micro)thrombosis in COVID-19 and its therapeutic implications. Circ Res. 2020; 127(4): 571–87. https://doi.org/10.1161/circresaha.120.317447. PMID: 32586214. PMCID: PMC7386875. 3. Bonaventura A., Vecchié A., Dagna L. et al. Endothelial dysfunction and immunothrombosis as key pathogenic mechanisms in COVID-19. Nat Rev Immunol. 2021; 21(5): 319–29. https://doi.org/10.1038/s41577-021-00536-9. PMID: 33824483. PMCID: PMC8023349. 4. Нестерова И.В., Атажахова М.Г., Тетерин Ю.В. с соавт. Роль нейтрофильных экстрацеллюлярных сетей (NETs) в иммунопатогенезе тяжелого COVID-19: потенциальные иммунотерапевтические стратегии, регулирующие процесс формирования и активность NETs. Инфекция и иммунитет. 2023; 13(1): 9–28. (Nesterova I.V., Atazhakhova M.G., Teterin Yu.V. et al. The role of neutrophil extracellular traps (NETs) in the immunopathogenesis of severe COVID-19: Potential immunotherapeutic strategies regulating NET formation and activity. Infektsiya i immunitet = Russian Journal of Infection and Immunity. 2023; 13(1): 9–28 (In Russ.)). https://doi.org/10.15789/2220-7619-TRO-2058. EDN: VLVURO. 5. Wulandari S., Hartono, Wibawa T. The role of HMGB1 in COVID-19-induced cytokine storm and its potential therapeutic targets: A review. Immunology. 2023; 169(2): 117–31. https://doi.org/10.1111/imm.13623. PMID: 36571562. PMCID: PMC9880760. 6. Martinod K., Deppermann C. Immunothrombosis and thromboinflammation in host defense and disease. Platelets. 2021; 32(3): 314–24. https://doi.org/10.1080/09537104.2020.1817360. PMID: 32896192. 7. Ghoshal K., Bhattacharyya M. Overview of platelet physiology: Its hemostatic and nonhemostatic role in disease pathogenesis. Scientific World Journal. 2014; 2014: 781857. https://doi.org/10.1155/2014/781857. PMID: 24729754. PMCID: PMC3960550. 8. Manne B.K., Xiang S.C., Rondina M.T. Platelet secretion in inflammatory and infectious diseases. Platelets. 2017; 28(2): 155–64. https://doi.org/10.1080/09537104.2016.1240766. PMID: 27848259. PMCID: PMC5734920. 9. Ан О.И., Мартьянов А.А., Степанян М.Г. с соавт. Тромбоциты при COVID-19: «случайные прохожие» или соучастники? Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2021; 20(1): 184–191. (An O.I., Martyanov A.A., Stepanyan M.G. et al. Platelets in COVID-19: “Innocent by-standers” or active participants? Voprosy gematologii/onkologii i immunopatologii v pediatrii = Pediatric Hematology/Oncology and Immunopathology. 2021; 20(1): 184–191 (In Russ.)). https://doi.org/10.24287/1726-1708-2021-20-1-184-191. EDN: UEKZRK. 10. Zhong Q., Peng J. Mean platelet volume/platelet count ratio predicts severe pneumonia of COVID-19. J Clin Lab Anal. 2021; 35(1): e23607. https://doi.org/10.1002/jcla.23607. PMID: 33128497. PMCID: PMC7843293. 11. Le V.B., Schneider J.G., Boergeling Y. et al. Platelet activation and aggregation promote lung inflammation and influenza virus pathogenesis. Am J Respir Crit Care Med. 2015; 191(7): 804–19. https://doi.org/10.1164/rccm.201406-1031OC. PMID: 25664391. 12. Gao Y., Li T., Han M. et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020; 92(7): 791–96. https://doi.org/10.1002/jmv.25770. PMID: 3218191.1 PMCID: PMC7228247. 13. Chu S.G., Becker R.C., Berger P.B. et al. Mean platelet volume as a predictor of cardiovascular risk: A systematic review and meta-analysis. J Thromb Haemost. 2010; 8(1): 148–56. https://doi.org/10.1111/j.1538-7836.2009.03584.x. PMID: 19691485. PMCID: PMC3755496. 14. Ahmadi E., Bagherpour Z., Zarei E. et al. Pathological effects of SARS-CoV-2 on hematological and immunological cells: Alterations in count, morphology, and function. Pathol Res Pract. 2022; 231: 153782. https://doi.org/10.1016/j.prp.2022.153782. PMID: 35121363. PMCID: PMC8800420. 15. Qu R., Ling Y., Zhang Y.H. et al. Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020; 92(9): 1533–41. https://doi.org/10.1002/jmv.25767. PMID: 32181903. PMCID: PMC7228291. 16. Sarkar S., Kannan S., Khanna P. et al. Role of platelet-to-lymphocyte count ratio (PLR), as a prognostic indicator in COVID-19: A systematic review and meta-analysis. J Med Virol. 2022; 94(1): 211–21. https://doi.org/10.1002/jmv.27297. PMID: 34436785. PMCID: PMC8661888. 17. Гашимова Н.Р., Бицадзе В.О., Панкратьева Л.Л. с соавт. Дисрегуляция функции тромбоцитов у больных COVID-19. Акушерство, гинекология и репродукция. 2022; 16(6): 692–705. (Gashimova N.R., Bitsadze V.O., Pankratyeva L.L. et al. Dysregulated platelet function in COVID-19 patients. Akusherstvo, ginekologiya i reprodukciya = Obstetrics, Gynecology and Reproduction. 2022; 16(6): 692–705 (In Russ.)). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2022.372. EDN: AYGTRY. 18. Wool G.D., Miller J.L. The impact of COVID-19 disease on platelets and coagulation. Pathobiology. 2021; 88(1): 15–27. https://doi.org/10.1159/000512007. PMID: 33049751. PMCID: PMC7649697. 19. Koltai K., Kesmarky G., Feher G. et al. Platelet aggregometry testing: Molecular mechanisms, techniques and clinical implications. Int J Mol Sci. 2017; 18(8): 1803. https://doi.org/10.3390/ijms18081803. PMID: 28820484. PMCID: PMC5578190. 20. Пономаренко Е.А., Игнатова А.А., Федорова Д.В. с соавт. Функциональная активность тромбоцитов: физиология и методы лабораторной диагностики. Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2019; 18(3): 112–119. (Ponomarenko E.A., Ignatova A.A., Fedorova D.V. et al. Platelet functional activity: physiology and laboratory diagnostic methods. Voprosy gematologii/onkologii i immunopatologii v pediatrii = Pediatric Hematology/Oncology and Immunopathology. 2019; 18(3): 112–119 (In Russ.)). https://doi.org/10.24287/1726-1708-2019-18-3-112-119. EDN: EQBSCQ.
About the Autors
Leonid I. Kadnikov, MD, postgraduate student, Department of pharmacology and clinical pharmacology, Ural State Medical University of the Ministry of Healthcare of Russia. Address: 620028, Yekaterinburg, 3 Repina St.
E-mail: kadn-leonid@mail.ru
ORCID: https://orcid.org/0000-0002-2623-2657
Nadezhda V. Izmozherova, MD, Dr. Sci. (Medicine), head of the Department of pharmacology and clinical pharmacology, Ural State Medical University of the Ministry of Healthcare of Russia, leading researcher at the Institute of High-Temperature Electrochemistry, Ural branch of the Russian Academy of Sciences. Address: 620028, Yekaterinburg, 3 Repina St.
E-mail: nadezhda_izm@mail.ru
ORCID: https://orcid.org/0000-0001-7826-9657
Artem A. Popov, MD, Dr. Sci. (Medicine), head of the Department of hospital therapy and emergency medical care, Ural State Medical University of the Ministry of Healthcare of Russia, leading researcher at the Institute of High-Temperature Electrochemistry, Ural branch of the Russian Academy of Sciences. Address: 620028, Yekaterinburg, 3 Repina St.
E-mail: art_popov@mail.ru
ORCID: https://orcid.org/0000-0001-6216-2468
Irina P. Antropova, MD, Dr. Sci. (Biology), leading researcher at the Central Research Department, Ural state medical university of the Ministry of Healthcare of Russia, leading researcher at the Institute of High-Temperature Electrochemistry, Ural branch of the Russian Academy of Sciences. Address: 620109, Yekaterinburg, 5 Klyuchevskaya St.
E-mail: aip.hemolab@mail.ru
ORCID: https://orcid.org/0000-0002-9957-2505
Similar Articles
