tetano
Editor, Senior Moderator
Thromb Haemost
. 2021 Feb 5.
doi: 10.1055/s-0041-1722919. Online ahead of print.
Assessment of Platelet Thrombus Formation under Flow Conditions in Adult Patients with COVID-19: An Observational Study
Stefano Ghirardello[SUP] 1 [/SUP], Anna Lecchi[SUP] 2 [/SUP], Andrea Artoni[SUP] #[/SUP][SUP] 2 [/SUP], Mauro Panigada[SUP] #[/SUP][SUP] 3 [/SUP], Stefano Aliberti[SUP] 4 5 [/SUP], Erica Scalambrino[SUP] 2 [/SUP], Silvia La Marca[SUP] 2 [/SUP], Marco Boscarino[SUP] 2 [/SUP], Andrea Gramegna[SUP] 4 [/SUP], Paolo Properzi[SUP] 3 [/SUP], Chiara Abruzzese[SUP] 3 [/SUP], Francesco Blasi[SUP] 4 5 [/SUP], Giacomo Grasselli[SUP] 3 5 [/SUP], Fabio Mosca[SUP] 1 6 [/SUP], Armando Tripodi[SUP] 2 [/SUP], Flora Peyvandi[SUP] 2 5 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) is associated with systemic inflammation, which may dysregulate platelet function. Total Thrombus-Formation Analysis System (T-TAS) is a flow-chamber device that analyses platelet-mediated thrombus formation in capillary channels through the following parameters: (1) the area under the flow-pressure curve (AUC), (2) occlusion start time (OST), time needed to reach OST, and (3) occlusion time (OT), time needed to reach the occlusion pressure.
Methods and findings: Sixty-one COVID-19 patients admitted to intensive, subintensive, and low intensive care were prospectively enrolled according to the time of admission: group A (up to 8 days) (n = 18); group B (from 9 to 21 days) (n = 19), and group C ( > 21 days) (n = 24). T-TAS measurements were performed at enrolment and after 7 days. Median OST was similar among groups. AUC was lower in group A compared to B (p = 0.001) and C (p = 0.033). OT was longer in group A compared to B (p = 0.001) and C (p = 0.028). Platelet count (PC) was higher in group B compared to A (p = 0.024). The linear regression showed that OT and AUC were independent from PC in group A (OT: 0.149 [95% confidence interval [CI]: -0.326 to 0.624], p = 0.513 and AUC: 0.005 [95% CI: -0.008 to 0.017], p = 0,447). In contrast, in group B, PC was associated with OT (-0.019 [-0.028 to 0.008], p = 0.023) and AUC (0.749 [0.358-1.139], p = 0,015), similarly to group C. Conversely, patients with different illness severity had similar T-TAS parameters.
Conclusion: COVID-19 patients display an impaired platelet thrombus formation in the early phase of the disease compared to later stages and controls, independently from illness severity.
. 2021 Feb 5.
doi: 10.1055/s-0041-1722919. Online ahead of print.
Assessment of Platelet Thrombus Formation under Flow Conditions in Adult Patients with COVID-19: An Observational Study
Stefano Ghirardello[SUP] 1 [/SUP], Anna Lecchi[SUP] 2 [/SUP], Andrea Artoni[SUP] #[/SUP][SUP] 2 [/SUP], Mauro Panigada[SUP] #[/SUP][SUP] 3 [/SUP], Stefano Aliberti[SUP] 4 5 [/SUP], Erica Scalambrino[SUP] 2 [/SUP], Silvia La Marca[SUP] 2 [/SUP], Marco Boscarino[SUP] 2 [/SUP], Andrea Gramegna[SUP] 4 [/SUP], Paolo Properzi[SUP] 3 [/SUP], Chiara Abruzzese[SUP] 3 [/SUP], Francesco Blasi[SUP] 4 5 [/SUP], Giacomo Grasselli[SUP] 3 5 [/SUP], Fabio Mosca[SUP] 1 6 [/SUP], Armando Tripodi[SUP] 2 [/SUP], Flora Peyvandi[SUP] 2 5 [/SUP]
Affiliations
- PMID: 33545735
- DOI: 10.1055/s-0041-1722919
Abstract
Background: Coronavirus disease 2019 (COVID-19) is associated with systemic inflammation, which may dysregulate platelet function. Total Thrombus-Formation Analysis System (T-TAS) is a flow-chamber device that analyses platelet-mediated thrombus formation in capillary channels through the following parameters: (1) the area under the flow-pressure curve (AUC), (2) occlusion start time (OST), time needed to reach OST, and (3) occlusion time (OT), time needed to reach the occlusion pressure.
Methods and findings: Sixty-one COVID-19 patients admitted to intensive, subintensive, and low intensive care were prospectively enrolled according to the time of admission: group A (up to 8 days) (n = 18); group B (from 9 to 21 days) (n = 19), and group C ( > 21 days) (n = 24). T-TAS measurements were performed at enrolment and after 7 days. Median OST was similar among groups. AUC was lower in group A compared to B (p = 0.001) and C (p = 0.033). OT was longer in group A compared to B (p = 0.001) and C (p = 0.028). Platelet count (PC) was higher in group B compared to A (p = 0.024). The linear regression showed that OT and AUC were independent from PC in group A (OT: 0.149 [95% confidence interval [CI]: -0.326 to 0.624], p = 0.513 and AUC: 0.005 [95% CI: -0.008 to 0.017], p = 0,447). In contrast, in group B, PC was associated with OT (-0.019 [-0.028 to 0.008], p = 0.023) and AUC (0.749 [0.358-1.139], p = 0,015), similarly to group C. Conversely, patients with different illness severity had similar T-TAS parameters.
Conclusion: COVID-19 patients display an impaired platelet thrombus formation in the early phase of the disease compared to later stages and controls, independently from illness severity.