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. 2021 Feb 22;16(2):e0246806.
doi: 10.1371/journal.pone.0246806. eCollection 2021.

Circulating microparticles and activated platelets as novel prognostic biomarkers in COVID-19; relation to cancer

Asmaa M Zahran  1 , Omnia El-Badawy  2 , Wageeh A Ali  3 , Zainab Gaber Mahran  4 , Essam Eldeen M O Mahran  4 , Amal Rayan  5
Affiliations

Circulating microparticles and activated platelets as novel prognostic biomarkers in COVID-19; relation to cancer

Asmaa M Zahran et al. PLoS One. .

Abstract

Background and aim: The study aimed to determine whether the MPs levels and platelet activation are affected by the COVID-19 infection in both malignant and non-malignant patients compared to healthy individuals and define their contribution to the COVID-19 associated coagulopathy and the relation of these MPs to other hematologic parameters.

Patients and methods: We recruited 23 malignant patients with reverse transcription polymerase chain reaction (RT-PCR) positive COVID-19, also, 19 COVID-19 non-malignant patients, and 20 healthy volunteers were also enrolled for comparison. Blood samples were collected from patients and healthy donors into 5 mL vacutainer tube containing 3.5% buffered sodium citrate solution for measurement of total microparticles (TMPs), platelet microparticles (PMPs), endothelial microparticles (EMPs), CD62 activated platelets, and CD41 platelet marker.

Results: COVID-19 malignant patients had significantly lower hemoglobin and platelets compared to COVID non-malignant ones, while they had significantly higher C-reactive protein, LDH, AST, Albunim, creatinine, and prognostic index (PI) compared to COVID-19 non-malignant patients. significant accumulations of TMPs, PMPs, EMPs, and activated platelets in COVID-19 affected patients compared to healthy controls. TMPs, and EMPs were significantly accumulated in COVID-19 malignant compared to COVID-19 non-malignant patients with no significant difference in PMPs between both.

Conclusion: Circulating MPs and activated platelets may be promising novel prognostic biomarkers capable of identifying potentially severe COVID-19 patients who require immediate care especially in cancer patients.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow cytometry gating strategy of microparticles (MPs).
A: The MPs were identified in a forward/side scatter histogram (R1) using calibrated beads. B: The expression of annexin V was then assessed within the defined MP population, and the annexin V-positive MPs (total MPs) were quantified (R2). C & D: Total MPs were further analyzedfor the expression of CD41, CD45, and CD146 to detect the platelet MPs (CD41+ MPs) and the endothelial derived MPs (CD45-CD146+ MPs).
Fig 2
Fig 2. Flow cytometric detection of activated platelets.
A:a forward/side scatter plot was used to identify platelets (R1). B: platelets expressing CD62P weremeasuredamong the CD41 positive events (activated platelets).
Fig 3
Fig 3. Differences in the mean values of MPs according to GGO score.
Fig 4
Fig 4. Relations between severities of GGO to hematologic parameters and age.
Fig 5
Fig 5. Relation between severities of GGO to ferritin level.
See this image and copyright information in PMC

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