Abstract Number: LPB0103
Meeting: ISTH 2021 Congress
Background: COVID-19 triggers a pro-inflammatory and pro-thrombotic state. The role of circulating cellular clusters in the setting of COVID-19 remains unclear.
Aims: This study explores the phenotype of circulating clusters and their potential relationship with clinical outcomes in COVID-19 patients.
Methods: Blood samples were collected between July – August 2020 from patients with a positive SARS-CoV2 PCR treated at a large academic medical center. Imaging flow cytometry was used to detect various circulating cellular clusters, including: platelet (plt)-leukocyte aggregates (PLAs: 1 leukocyte + plt), leukocyte clusters (LC: >2 leukocytes ± any other cell) and platelet-erythrocyte aggregates (PEAs: >1 erythrocyte + plt) (Figure 1). Cluster phenotypes were compared in patients with and without COVID-19 and were retrospectively correlated with clinical outcomes.
Results: Forty-six COVID and 12 non-COVID samples were analyzed. Patients with COVID-19 had higher circulating PEAs (2.58% ± 0.12% vs 1.41% ± 0.72%, p=.001) and manually-counted PLAs (0.15% ± 0.11% vs. 0.06% ± 0.03% p=.007) compared to healthy controls. Table 1 shows the relationship between specific populations of clusters and clinical outcomes in patients with COVID-19. The presence of LCs, in particular, significantly correlated with thrombotic events (p=0.006), whereas PLAs and PEAs did not (p=0.73 and p=0.9, respectively). Blood type was also correlated to LCs (p=0.021), with Type O having the least LCs, followed by Types A, AB and B.
|Mortality||Admitted to ICU||Mechanical Ventilation||Acute Kidney Injury||Thrombotic Complication||Infectious Complication|
|PEAs||p= 0.31||p= 0.13||p= 0.04||p= 0.11||p= 0.90||p= 0.045|
|PLAs||p= 0.41||p= 0.28||p= 0.47||p= 0.73||p= 0.73||p= 0.54|
|LCs||p= 0.49||p= 0.67||p= 0.91||p= 0.07||p= 0.006||p= 0.36|
|Thrombotic complication: Deep vein thrombosis, pulmonary embolism, clotting in lines, myocardial infarction, stroke or acute bowel ischemia.
Infectious complications: Pneumonia, CLABSI, surgical site infection or UTI.
Conclusions: Circulating cellular clusters are correlated with significant clinical outcomes and cluster phenotypes appear to be associated with specific outcomes, including thrombotic events. These immuno-thrombotic complexes may play a significant role in the development of thrombosis and resultant end-organ damage. Further study of the role of the cellular component in COVID-19 may lead to the development of prediction models and help identify novel drug targets for inflammation-related thrombosis.
To cite this abstract in AMA style:Dorken Gallastegi A, Naar L, Van Cott EM, Rosovsky RP, Gregory DJ, Annamalai D, Lee J, Kaafarani HMA, Velmahos G, Tompkins RG, Frydman GH. Circulating Cellular Clusters Are Correlated with Thrombotic Complications and Clinical Outcomes in COVID-19 [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/circulating-cellular-clusters-are-correlated-with-thrombotic-complications-and-clinical-outcomes-in-covid-19/. Accessed December 6, 2023.
« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/circulating-cellular-clusters-are-correlated-with-thrombotic-complications-and-clinical-outcomes-in-covid-19/