Abstract Number: PB/CO12
Meeting: ISTH 2020 Congress
Background: COVID-19 is a global pandemic with patients at increased risk for thrombosis. Platelets are central protagonists of thrombosis, and virus-platelet interactions are linked to viral pathogenesis and increased thrombotic risk.
Aims: To investigate the relationship between in vivo platelet activity markers, and thrombosis or death in hospitalized patients with COVID-19.
Methods: Plasma samples were collected from 100 hospitalized patients on the day of PCR-confirmed COVID-19 diagnosis. Thromboxane B2 (TxB2), P-selectin (P-selectin), and soluble CD40 ligand (sCD40L) were measured in plasma, and mean platelet volume (MPV) assessed. Subjects were followed until discharge or death, and thrombotic events recorded.
Results: Among 100 patients, the median age was 65 years (IQR: 55, 75), 39% were female, and 32 died or experienced a thrombotic event. Baseline platelet activation markers were higher in patients who developed an adverse clinical event. After adjustment for age, sex, race/ethnicity, platelet count, antiplatelet therapy, and chronic obstructive pulmonary disease, TxB2 (p=0.006), P-selectin (p=0.005), sCD40L (p=0.016), and MPV (p=0.012) were independently associated with thrombosis or death (Table 1). Correlation analysis between biomarkers identified that TxB2 is correlated with P-selectin (ρ=0.42, p< 0.0001) and platelet count (ρ=0.35, p=0.0004), MPV is correlated with platelet count (ρ=-0.31, p=0.002), and P-selectin is correlated with sCD40L (ρ=0.67, p< 0.0001).
|OR [95% CI]||P value|
|MPV||2.17 [1.22, 4.15]||0.012|
|sCD40L||1.94 [1.15, 3.43]||0.016|
|P-selectin||2.36 [1.36, 4.56]||0.005|
|TxB2||2.59 [1.37, 5.43]||0.006|
[Table 1. Multivariable regression models predicting thrombosis or all-cause mortality.]
Conclusions: Biomarkers of platelet activation are significantly associated with death or thrombosis in patients hospitalized with COVID-19. Our findings suggest multiple platelet activation mechanisms may contribute to adverse events. Further investigation into the mechanistic role of platelets in COVID-19 pathogenesis and the potential role of antiplatelet therapy is warranted.
To cite this abstract in AMA style:Barrett T, Lee A, Xia Y, Hsulin L, Black M, Cotzia P, Hochman J, Berger J. Platelet Activation is Associated with Thrombosis or Death in Patients with COVID-19 [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/platelet-activation-is-associated-with-thrombosis-or-death-in-patients-with-covid-19/. Accessed October 1, 2023.
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