Platelet Reactivity and Coagulation Markers in Patients with COVID-19

Author(s):Show less -

Bertolin, Adriadne J. ^[1] ; Dalcoquio, Talia F. ^[1] ; Salsoso, Rocio ^[1] ; de M. Furtado, Remo H. ^{[2, 1]} ; Kalil-Filho, Roberto ^[1] ; Hajjar, Ludhmila A. ; Siciliano, Rinaldo F. ^[3] ; Kallas, Esper G. ^[3] ; Baracioli, Luciano M. ; Lima, Felipe G. ^[1] ; Giraldez, Roberto R. ^[1] ; Cavalheiro-Filho, Cyrillo ^[1] ; Vieira, Alexandra ^[1] ; Strunz, Celia M. C. ^[1] ; Giugliano, Robert P. ^{[4, 5]} ; Tantry, Udaya S. ^{[4, 5]} ; Gurbel, Paul A. ^[6] ; Nicolau, Jose C. ^[1]

Affiliation

^[1] Univ Sao Paulo, Hosp Clin HCFMUSP, Inst Coracao InCor, Fac Med, Sao Paulo, SP - Brazil

^[2] Hosp Israelita Albert Einstein, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Dept Infect & Parasit Dis, Sao Paulo, SP - Brazil

^[4] Harvard Med Sch, Boston, MA 02115 - USA

^[5] Brigham & Womens Hosp, Dept Med, Cardiovasc Div, TIMI Study Grp, 75 Francis St, Boston, MA 02115 - USA

^[6] Sinai Hosp Baltimore, Sinai Ctr Thrombosis Res & Drug Dev, Baltimore, MD - USA

• Document type: Journal article
• Source: ADVANCES IN THERAPY; v. 38, n. 7, p. 3911-3923, JUL 2021.
• Web of Science Citations: 1

Abstract

Introdution COVID-19 is associated with an increased risk of thrombotic events. However, the contribution of platelet reactivity (PR) to the aetiology of the increased thrombotic risk associated with COVID-19 remains unclear. Our aim was to evaluate PR in stable patients diagnosed with COVID-19 and hospitalized with respiratory symptoms (mainly dyspnoea and dry cough), in comparison with a control group comprised of non-hospitalized healthy controls. Methods Observational, case control study that included patients with confirmed COVID-19 (COVID-19 group, n = 60) and healthy individuals matched by age and sex (control group, n = 60). Multiplate electrode aggregometry (MEA) tests were used to assess PR with adenosine diphosphate (MEA-ADP, low PR defined as < 53 AUC), arachidonic acid (MEA-ASPI, low PR < 86 AUC) and thrombin receptor-activating peptide 6 (MEA-TRAP, low PR < 97 AUC) in both groups. Results The rates of low PR with MEA-ADP were 27.5% in the COVID-19 group and 21.7% in the control group (OR = 1.60, p = 0.20); with MEA-ASPI, the rates were, respectively, 37.5% and 22.5% (OR = 3.67, p < 0.001); and with MEA-TRAP, the incidences were 48.5% and 18.8%, respectively (OR = 9.58, p < 0.001). Levels of d-dimer, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) were higher in the COVID-19 group in comparison with the control group (all p < 0.05). Thromboelastometry was utilized in a subgroup of patients and showed a hypercoagulable state in the COVID-19 group. Conclusion Patients hospitalized with non-severe COVID-19 had lower PR compared to healthy controls, despite having higher levels of d-dimer, fibrinogen, and PAI-1, and hypercoagulability by thromboelastometry. (AU)

• FAPESP's process: 20/04705-2 - Diagnostic and prognostic study of SARS-CoV-2 and Influenza virus infection
• Grantee: José Carlos Nicolau
• Support Opportunities: Regular Research Grants