Luzak Boguslawa, Golanski Jacek, Rozalski Marcin
Department of Hemostasis and Hemostatic Disorders, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland.
Int J Mol Sci. 2024 Dec 24;26(1):49. doi: 10.3390/ijms26010049.
COVID-19 and post-COVID (long COVID) are associated with thromboembolic complications; however, it is still not clear whether platelets play a leading role in this phenomenon. The platelet hyperreactivity could result from the direct interaction between platelets and viral elements or the response to inflammatory and prothrombotic factors released from blood and vessel cells following infection. The existing literature does not provide clear-cut answers, as the results determining platelet status vary according to methodology. Elevated levels of soluble markers of platelet activation (P selectin, PF4), increased platelet aggregates, and platelet-derived microparticles suggest the activation of platelets circulating in the bloodstream of COVID-19 patients. Similarly, platelets isolated from COVID-19 patients demonstrate increased reactivity in response to collagen, thrombin, and ADP. By contrast, an analysis of whole blood from COVID-19 patients indicates the reduced activation of the fibrinogen receptor. Similarly, some in vitro studies report potential targets for SARS-CoV-2 in platelets, whereas others do not indicate any direct effect of the virus on platelets. The aim of this work is to review and evaluate the reliability of the methodology for testing platelet function after contact with SARS-CoV-2. Despite the diversity of methods yielding varying results and the influence of plasma components or blood cells, it can be concluded that platelets play an important role in the development of thrombotic complications after exposure to SARS-CoV-2.
新冠病毒感染（COVID-19）及感染后状况（长期新冠，long COVID）与血栓栓塞并发症相关；然而，血小板在这一现象中是否起主导作用仍不清楚。血小板高反应性可能源于血小板与病毒成分的直接相互作用，或对感染后血液及血管细胞释放的炎症和促血栓形成因子的反应。现有文献并未给出明确答案，因为根据检测方法不同，所确定的血小板状态结果也有所不同。血小板活化的可溶性标志物（P选择素、PF4）水平升高、血小板聚集体增加以及血小板衍生微粒增多，提示新冠患者血液中循环血小板的活化。同样，从新冠患者分离出的血小板对胶原蛋白、凝血酶和二磷酸腺苷（ADP）的反应性增强。相比之下，对新冠患者全血的分析表明纤维蛋白原受体的活化降低。类似地，一些体外研究报告了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在血小板中的潜在靶点，而其他研究则未表明该病毒对血小板有任何直接影响。这项工作的目的是回顾和评估检测与SARS-CoV-2接触后血小板功能方法的可靠性。尽管方法多样导致结果各异，且受血浆成分或血细胞的影响，但可以得出结论，血小板在接触SARS-CoV-2后血栓并发症的发生中起重要作用。
