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. 2021 Jul;38(7):3911-3923.
doi: 10.1007/s12325-021-01803-w. Epub 2021 Jun 4.

Platelet Reactivity and Coagulation Markers in Patients with COVID-19

Adriadne J Bertolin  1 , Talia F Dalçóquio  1 , Rocío Salsoso  1 , Remo H de M Furtado  1   2 , Roberto Kalil-Filho  1 , Ludhmila A Hajjar  1 , Rinaldo F Siciliano  1   3 , Esper G Kallás  3 , Luciano M Baracioli  1 , Felipe G Lima  1 , Roberto R Giraldez  1 , Cyrillo Cavalheiro-Filho  1 , Alexandra Vieira  1 , Célia M C Strunz  1 , Robert P Giugliano  4 , Udaya S Tantry  4 , Paul A Gurbel  5 , José C Nicolau  6
Affiliations

Platelet Reactivity and Coagulation Markers in Patients with COVID-19

Adriadne J Bertolin et al. Adv Ther. 2021 Jul.

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.

Trial registration: ClinicalTrials.gov identifier, NCT04447131.

Keywords: COVID-19; Multiplate electrode aggregometry; Platelet reactivity; Thromboelastometry.

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Figures

Fig. 1
Fig. 1
Flowchart of selection criteria
Fig. 2
Fig. 2
Correlation between platelet reactivity and hospital length of stay
See this image and copyright information in PMC

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