Distinct phenotypes of platelet, monocyte, and neutrophil activation occur during the acute and convalescent phase of COVID-19

Abstract

SARS-CoV-2 has spread rapidly worldwide, causing the COVID-19 pandemic. Platelet activation and platelet-leukocyte complex formation are proposed to contribute to disease progression. Here, we report platelet and leukocyte activation during acute and convalescent COVID-19 in patients recruited between May-July 2020. Blood samples were analyzed by flow cytometry and ELISA using paired comparison between inclusion (day 0) and 28 days later. The majority of patients were mildly or moderately ill with significantly higher cytokine levels (IL-6 and IL-10) on day 0 as compared with day 28. Platelet activation and granule release were significantly higher on day 0 compared with day 28, as determined by ADP-or thrombin-induced surface CD62P expression, baseline released CD62P, and thrombin-induced platelet-monocyte complex formation. Monocyte activation and procoagulant status at baseline and post activation were heterogeneous but generally lower on day 0 compared with day 28. Baseline and thrombin-or fMLF-induced neutrophil activation and procoagulant status were significantly lower on day 0 compared with day 28. We demonstrate that during the acute phase of COVID-19 compared with the convalescent phase, platelets are more responsive while neutrophils are less responsive. COVID-19 is associated with thromboembolic events where platelet activation and interaction with leukocytes may play an important role.

Persistence of SARS-CoV-2 total immunoglobulins in a series of convalescent plasma and blood donors

“…It is well known that several infectious agents such as malaria have prothrombotic effects, which happen as well in bacterial sepsis [ 24 ]. It has been elsewhere reported an elevation of platelets and their activation, and a lower number and activity of neutrophils in COVID-19 cases irrespective of their severity [ 25 ] accordingly to our data.…”

Longitudinal multiparametric characterization of platelet dysfunction in COVID-19: Effects of disease severity, anticoagulation therapy and inflammatory status

“…3 B). Thus, platelets in COVID-19 are “slow responders”, which is in line with the findings of Chao et al [50] . This also implies plasma hypercoagulation significance for platelet dysfunction, described earlier for other diseases [51] .…”

Incidence and affecting factors of pulmonary diffusing capacity impairment with COVID-19 survivors 18 months after discharge in Wuhan, China

“…In the acute phase, PLT activation and aggregation of COVID-19 patients were increased 6 , 7 . Histopathological assessment on the autopsy of COVID-19 cases revealed presence of PLT-involved inflammatory microvascular thrombosis in the patients’ lungs, kidneys and hearts, confirming that respiratory failure of COVID-19 patients was connected with inflammatory thrombosis 8 , 9 , 10 .…”