Coronavirus disease 2019 (COVID-19) has already caused severe health and economic burdens worldwide and, as of May 15, 2020, has claimed 60 300 total deaths in the United States. 1 COVID-19 presents with various symptoms which include increased inflammatory cytokines, dysregulated coagulation parameters, increased D-dimer, increased microthrombi and reduced platelet count. 2 In COVID-19 patients, disseminated intravascular coagulation and reduced platelet count are associated with poor prognosis and increased risk of mortality. 2-4 These clinical observations suggest that platelets may serve important functions during COVID-19 progression. To understand how the incidence of microthrombosis and reduced platelet count may occur during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it is necessary to look at the potential active versus reactive roles of platelets during progression of SARS-CoV-2 infection. The first stage of infection involves viral replication in epithelial cells of the respiratory tract. SARS-CoV-2 is a single-stranded RNA virus classified as β-coronavirus. It is an upper respiratory virus that, similarly to influenza, becomes problematic when it reaches the lower lung epithelial cells. These cells comprise the lining of the alveolar sacs and are located in very close proximity to the capillary endothelial cells. This proximity established by both cell types is instrumental to gas exchange. In the capillary, platelets are essential in mediating endothelial integrity by performing their hemostatic function. 5 During infection with respiratory viruses, however, the integrity of infected epithelial and endothelial cells becomes compromised, leading to increased permeability that may allow virus to crossover into the circulation. Limited presence of SARS-CoV2 RNA in blood has been reported in some patients. 6 Of note, viral RNA tested by quantitative polymerase chain reaction (qPCR) does not indicate presence of infectious virus in blood. qPCR can amplify fragmented RNA while plaque assays are appropriate for determination of infectious virus. Due to their abundance, platelets may be the first blood component to internalize viral particles and induce a response once the pathogen reaches circulation. For example, although viremia (infectious virus in blood) is considered rare, platelets from influenza-infected patients have been found to contain influenza particles. 7