Uzun Günalp, Pelzl Lisann, Singh Anurag, Bakchoul Tamam
Center for Clinical Transfusion Medicine, University Hospital of Tuebingen, Tuebingen, Germany.
Institute of Clinical and Experimental Transfusion Medicine, University Hospital of Tuebingen, Tuebingen, Germany.
Front Immunol. 2022 Feb 22;13:837629. doi: 10.3389/fimmu.2022.837629. eCollection 2022.
Both qualitative and quantitative platelet abnormalities are common in patients with coronavirus disease 2019 (COVID-19) and they correlate with clinical severity and mortality. Activated platelets contribute to the prothrombotic state in COVID-19 patients. Several groups have shown immune-mediated activation of platelets in critically ill COVID-19 patients. Vaccine-induced immune thrombotic thrombocytopenia is an autoimmune condition characterized by thrombocytopenia and life-threatening thrombotic events in the arterial and venous circulation. Although the initial trigger has yet to be determined, activation of platelets by immune complexes through Fc gamma RIIA results in platelet consumption and thrombosis. A better understanding of platelet activation in COVID-19 as well as in vaccine-induced thrombotic complications will have therapeutic implications. In this review, we focused on the role of immune-mediated platelet activation in thrombotic complications during COVID-19 infection and vaccine-induced immune thrombotic thrombocytopenia.
定性和定量的血小板异常在2019冠状病毒病（COVID-19）患者中都很常见，并且它们与临床严重程度和死亡率相关。活化的血小板促成了COVID-19患者的血栓前状态。多个研究团队已表明，重症COVID-19患者存在免疫介导的血小板活化。疫苗诱导的免疫性血栓性血小板减少症是一种自身免疫性疾病，其特征为血小板减少以及动脉和静脉循环中危及生命的血栓形成事件。尽管初始触发因素尚未确定，但免疫复合物通过FcγRIIA激活血小板会导致血小板消耗和血栓形成。更好地了解COVID-19以及疫苗诱导的血栓性并发症中的血小板活化将具有治疗意义。在本综述中，我们重点关注免疫介导的血小板活化在COVID-19感染期间的血栓性并发症以及疫苗诱导的免疫性血栓性血小板减少症中的作用。
