Original Paper   

Minerva Anestesiologica 2022 Mar 22

DOI: 10.23736/S0375-9393.22.16054-2

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Platelet activation state in early stages of Covid-19

Filippo CONSOLO ^{1, 2} ✉, Patrizia DELLA VALLE ³, Marco SARACINO ², Marta BONORA ¹, Giovanni DONADONI ⁴, Fabio CICERI ^{1, 5}, Moreno TRESOLDI ⁶, Armando D’ANGELO ³, Giovanni LANDONI ^{1, 2}, Alberto ZANGRILLO ^{1 ,2}

¹ Università Vita Salute San Raffaele, Milano, Italy; ² Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milano, Italy; ³ Coagulation Service and Thrombosis Research Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy; ⁴ Emergency Department, IRCCS San Raffaele Scientific Institute, Milano, Italy; ⁵ Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy; ⁶ General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy

BACKGROUND: Platelet activation at the early stage of COVID-19 is poorly described. The need for antiplatelet therapy in patients with COVID-19 remains controversial. We characterized the platelet activation profile in hospitalized patients at the early stage of COVID-19 using the modified prothrombinase Platelet Activation State (PAS) assay.
METHODS: Sixteen patients admitted to the emergency department of the IRCCS San Raffaele Scientific Institute (Milano, Italy) between February 8 and April 2021 were enrolled. All patients presented with respiratory symptoms and tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Platelet activation was measured via the PAS assay within 24 hours from patients’ hospital admission. Data were compared with those measured in n=24 healthy subjects (controls).
RESULTS: Platelet activation was significantly higher in COVID-19 patients with respect to controls (PAS = 0.63 [0.58-0.98]% vs. 0.46 [0.40-0.65]%, respectively; p=0.03). Of note, highest PAS values were measured in the two patients with the worst clinical outcome, i.e., death because of respiratory failure (PAS = 2.09% and 1.20%, respectively). No differences in standard coagulation parameters were noted between these two patients and those who were later discharged home.
CONCLUSIONS: This study provides evidences of significant platelet activation state at the early stage of COVID-19 and suggests that the patient-specific platelet activation profile is a reliable clinical marker to stratify COVID-19 patients at high risk of poor clinical outcome who might potentially benefit from antiplatelet therapy.

KEY WORDS: Platelet activation; COVID-19; Thromboinflammation