Abstract Number: PB0137
Meeting: ISTH 2021 Congress
Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected over 100 million globally to date. Although high rates of venous thromboembolism and evidence of COVID-19-induced endothelial dysfunction have been reported, the precise aetiology of the increased thrombotic risk associated with COVID-19 infection remains to be fully elucidated. Several studies to date suggest a role for platelets in COVID-19-associated thrombosis.
Aims: To assess the impact of COVID-19 on platelet activity and to characterise the proteome of the platelet releasate from COVID-19 patients, compared with healthy controls.
Methods: Ethical approval was granted by the Institutional Review Board of the Mater Misericordiae University Hospital. Haematologic parameters of patients with severe COVID-19 disease (requiring intensive care; n=34), with non-severe disease (not requiring intensive care; n=20) and in general medical in-patients without COVID-19 (n=20) were assessed. Platelet function and activity were evaluated by secretion and platelet marker analysis (n=6 each cohort). The proteome of the platelet releasate was assessed using label-free mass spectrometry.
Results: We demonstrated agonist-induced ADP release was 30-to-90 fold higher in COVID-19 patients compared with hospitalised controls (Fig.1) and circulating levels of platelet-factor 4 (PF4), soluble P-selectin (sP-selectin) and thrombopoietin (TPO) were also significantly elevated in COVID-19. This study shows that COVID-19 patients possess hyperactive circulating platelets combined with a decreased activation threshold. Mass spectrometry analysis identified over 400 proteins from the releasate of COVID-19 patients and controls, including a multitude of inflammatory, vasoactive and vesicular proteins. The release of a subset of highly-relevant platelet proteins was modified based on the severity of COVID-19 infection.
Conclusions: Our data suggest abnormal platelet reactivity may contribute to hypercoagulability in COVID- 19. Platelet releasate analysis confirmed this finding, enabling novel insights into the pathology of COVID-19.
To cite this abstract in AMA style:Comer S, Cullivan S, Szklanna P, Weiss L, Cullen S, Kelliher S, Smolenski A, Murphy C, Altaie H, Curran J, O'Reilly K, Cotter A, Marsh B, Gaine S, Mallon P, McCullagh B, Moran N, Ní Áinle F, Kevane B, Maguire P. Impact of COVID-19 on Platelet Activity and the Platelet Releasate [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/impact-of-covid-19-on-platelet-activity-and-the-platelet-releasate/. Accessed September 16, 2021.
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