1. Platelets in the perspective of COVID-19; pathophysiology of thrombocytopenia and its implication as prognostic and therapeutic opportunity
- Author
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Shervin Shokouhi, Atieh Pourbagheri-Sigaroodi, Mahda Delshad, Behzad Poopak, Davood Bashash, and Ava Safaroghli-Azar
- Subjects
P-LCR, Platelet-large cell ratio ,VEGF, Vascular endothelial growth factor ,TMA, Thrombotic microangiopathy ,HIT, Heparin-induced thrombocytopenia ,MK, Megakaryocyte ,RP, Reticulated platelet ,SP, Severe pneumonia ,DIC, Disseminated intravascular coagulation ,BSH, British Society of Hematology ,TPO, Thrombopoietin ,Immunology and Allergy ,TNF-α, Tumor necrosis factor alpha ,Platelet ,sICAM-1, Soluble intercellular adhesion molecule 1 ,PTT, Partial thromboplastin time ,SARS-CoV-2, Severe acute respiratory syndrome–related coronavirus ,SOFA, Sequential Organ Failure Assessment ,HPCs, Hematopoietic progenitor cells ,International research ,BM, Bone marrow ,APLA, Anti-phospholipid antibodies ,HUS, Hemolytic-uremic syndrome ,Pillar ,MPR, Mean platelet volume/Platelet count ratio ,Prognosis ,AMI, Acute myocardial infarction ,TTP, Thrombotic thrombocytopenic purpura ,Pathophysiology ,PRRs, Pattern recognition receptors ,TGF-β, Transforming growth factor beta ,ICU, Intensive care unit ,MLP, Myeloproliferative leukemia protein ,HIV, Human immunodeficiency virus ,hrsACE2, Human recombinant soluble ACE2 ,PLT, Platelet ,ECMO, Extracorporeal membrane oxygenation ,JYS, Jianpi Yiqi Shexue ,IL-6, Interleukin 6 ,Respiratory virus ,DVT, Deep vein thrombosis ,VE, Vascular endothelial ,TCM, Traditional Chinese medicine ,TPO-RAs, TPO receptor agonists ,CFU, Colony-forming unit ,Blood Platelets ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,PDW, Platelet distribution width ,Immunology ,TPOR, TPO receptor ,PE, Pulmonary embolism ,Article ,FV, Factor V ,HCV, Hepatitis C virus ,HSCs, Hematopoietic stem cells ,S protein, Spike protein ,LA, Lupus anticoagulants ,ACE2, Angiotensin-converting enzyme 2 ,PT, prothrombin time ,medicine ,Coagulopathy ,Humans ,TCZ, Tocilizumab ,Intensive care medicine ,Ang-1, Angiopoietin 1 ,ComputingMethodologies_COMPUTERGRAPHICS ,IPF, Immature platelet fraction ,Pharmacology ,ITP, Immune thrombocytopenic purpura ,IVIg, Intravenous immunoglobulin ,NPA, Neutrophil–platelet aggregate ,SARS-CoV-2 ,business.industry ,sP-selectin, soluble form ,COVID-19 ,DRVVT, Dilute Russell's viper venom time ,IFN-α, Interferon alpha ,MPV, Mean platelet volume ,medicine.disease ,Thrombocytopenia ,SOCS1, Cytokine signaling 1 ,TLR7, Toll-like receptor 7 ,FDA, Food and drug administration ,SIV, Simian immunodeficiency virus ,CVC, Cenicriviroc ,MPA, Monocyte-platelet aggregate ,business ,APAS, Antiphospholipid antibody syndrome ,sIL-6R, Soluble IL-6R ,mAbs, Monoclonal antibodies - Abstract
Graphical abstract, Despite endorsed and exponential research to improve diagnostic and therapeutic strategies, efforts have not yet converted into a better prospect for patients infected with the novel coronavirus (2019nCoV), and still, the name of SARS-CoV-2 is coupled with numerous unanswered questions. One of these questions is concerning how this respiratory virus reduces the number of platelets (PLTs)? The results of laboratory examinations showed that about a quarter of COVID-19 cases experience thrombocytopenia, and more remarkably, about half of these patients succumb to the infection due to coagulopathy. These findings have positioned PLTs as a pillar in the management as well as stratifying COVID-19 patients; however, not all the physicians came into a consensus about the prognostic value of these cells. The current review aims to unravel the contributory role of PLTs s in COVID-19; and also to summarize the original data obtained from international research laboratories on the association between COVID-19 and PLT production, activation, and clearance. In addition, we provide a special focus on the prognostic value of PLTs and their related parameters in COVID-19. Questions on how SARS-CoV-2 induces thrombocytopenia are also responded to. The last section provides a general overview of the most recent PLT- or thrombocytopenia-related therapeutic approaches. In conclusion, since SARS-CoV-2 reduces the number of PLTs by eliciting different mechanisms, treatment of thrombocytopenia in COVID-19 patients is not as simple as it appears and serious cautions should be considered to deal with the problem through scrutiny awareness of the causal mechanisms.
- Published
- 2021
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