Abstract Number: PB0147
Meeting: ISTH 2021 Congress
Background: Coronavirus disease of 2019 (COVID-19) is associated with a prothrombotic state and high incidence of thrombotic events (TE). Platelet hyperreactivity has been reported in COVID-19 patients and might contribute to TE development.
Aims: To study platelet reactivity in hospitalized COVID-19 patients and to determine a possible association with the clinical outcomes thrombosis and all-cause mortality.
Methods: 79 hospitalized COVID-19 patients were enrolled in this retrospective cohort study and provided blood samples in which platelet reactivity in response to stimulation with ADP and TRAP-6 was determined using flow cytometry. Clinical outcomes included thrombotic events, and all-cause mortality.
Results: The incidence of TE in this study was 28% and all-cause mortality 16%. Patients that developed a TE were younger than patients that did not (median age of 55 versus 70 years; adjusted odds ratio (AOR), 0.96 per 1 year of age [95% CI, 0.92-1.00]; p = 0.042). Furthermore, patients using preexisting thromboprophylaxis were less likely to develop a TE than patients that were not (18% versus 54%; adjusted odds ratio, 0.18 [95% CI, 0.04-0.82]; p = 0.026). Conversely, having asthma strongly increased the risk on TE development (adjusted odds ratio, 6.4 [95% CI, 1.17-35.4]; p = 0.032). No significant differences in baseline P-selectin expression or platelet reactivity were observed between the COVID-19 positive patients (n=79) and COVID-19 negative hospitalized control patients (n=24), nor between COVID-19 survivors or non-survivors. However, patients showed decreased platelet reactivity in response TRAP-6 following TE development compared to patients without TE.
Conclusions: We observed an association between the use of preexisting thromboprophylaxis and a decreased risk of TE during COVID-19. This suggests that these therapies are beneficial for coping with COVID-19 associated hypercoagulability. This highlights the importance of patient therapy adherence. We observed lowered platelet reactivity after the development of TE, which might be attributed to platelet desensitization during thromboinflammation.
To cite this abstract in AMA style:Clark C, Jukema B, Barendrecht A, Spanjaard J, Jorritsma N, Smits S, de Maat S, Seinen C, Sebastian S, Koekman A, van Wesel A, van Goor H, Spijkerman R, Bongers S, van der Vries E, Nierkens S, Boes M, Koenderman L, Kaasjager K, Maas C. Thrombotic Events in COVID-19 Are Associated with a Lower Use of Prophylactic Anticoagulation Before Hospitalization and Followed by Decreases in Platelet Reactivity [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/thrombotic-events-in-covid-19-are-associated-with-a-lower-use-of-prophylactic-anticoagulation-before-hospitalization-and-followed-by-decreases-in-platelet-reactivity/. Accessed November 29, 2023.
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