Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Thromb Haemost. 2021 Aug;121(8):1087-1096. doi: 10.1055/s-0041-1722919. Epub 2021 Feb 5.
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.
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) ( = 18); group B (from 9 to 21 days) ( = 19), and group C ( > 21 days) ( = 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 ( = 0.001) and C ( = 0.033). OT was longer in group A compared to B ( = 0.001) and C ( = 0.028). Platelet count (PC) was higher in group B compared to A ( = 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], = 0.513 and AUC: 0.005 [95% CI: -0.008 to 0.017], = 0,447). In contrast, in group B, PC was associated with OT (-0.019 [-0.028 to 0.008], = 0.023) and AUC (0.749 [0.358-1.139], = 0,015), similarly to group C. Conversely, patients with different illness severity had similar T-TAS parameters.
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.
2019 年冠状病毒病（COVID-19）与全身炎症有关，这可能会使血小板功能失调。全血栓形成分析系统（T-TAS）是一种流动室设备，通过以下参数分析毛细血管通道中血小板介导的血栓形成：（1）流量-压力曲线下面积（AUC），（2）闭塞起始时间（OST），达到 OST 所需的时间，以及（3）闭塞时间（OT），达到闭塞压力所需的时间。
根据入院时间，前瞻性纳入 61 名入住重症、亚重症和低重症监护病房的 COVID-19 患者：A 组（最多 8 天）（n=18）；B 组（9 至 21 天）（n=19）和 C 组（ >21 天）（n=24）。在入组时和 7 天后进行 T-TAS 测量。组间 OST 中位数相似。与 B 组（=0.033）和 C 组（=0.001）相比，A 组 AUC 较低。与 B 组（=0.001）和 C 组（=0.028）相比，A 组 OT 较长。B 组血小板计数（PC）高于 A 组（=0.024）。线性回归显示，A 组 OT 和 AUC 与 PC 无关（OT：0.149 [95%置信区间 [CI]：-0.326 至 0.624]，=0.513 和 AUC：0.005 [95% CI：-0.008 至 0.017]，=0.447）。相比之下，B 组 PC 与 OT（-0.019 [-0.028 至 0.008]，=0.023）和 AUC（0.749 [0.358-1.139]，=0.015）相关，与 C 组相似。相反，不同疾病严重程度的患者具有相似的 T-TAS 参数。
与疾病后期和对照组相比，COVID-19 患者在疾病早期的血小板血栓形成能力受损，与疾病严重程度无关。
