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Association of Neutrophil Activation, More Than Platelet Activation, With Thrombotic Complications in Coronavirus Disease 2019.
- Source :
-
The Journal of infectious diseases [J Infect Dis] 2021 Mar 29; Vol. 223 (6), pp. 933-944. - Publication Year :
- 2021
-
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.<br />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.<br />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.<br />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.<br /> (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Biomarkers blood
Blood Platelets immunology
COVID-19 virology
Extracellular Traps
Female
Heparin, Low-Molecular-Weight blood
Humans
Male
Matrix Metalloproteinase 9 blood
Middle Aged
Neutrophil Activation
Neutrophils immunology
Platelet Activation
SARS-CoV-2 isolation & purification
Thrombosis virology
Venous Thromboembolism blood
Venous Thromboembolism immunology
Venous Thromboembolism virology
COVID-19 blood
COVID-19 immunology
Thrombosis blood
Thrombosis immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6613
- Volume :
- 223
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 33280009
- Full Text :
- https://doi.org/10.1093/infdis/jiaa756