Increased platelet activation and lower platelet-monocyte aggregates in COVID-19 patients with severe pneumonia

• Published in: PloS one 2023-03, Vol.18 (3), p.e0282785-e0282785
• Main Authors: Srihirun, Sirada, Sriwantana, Thanaporn, Srichatrapimuk, Sirawat, Vivithanaporn, Pornpun, Kirdlarp, Suppachok, Sungkanuparph, Somnuek, Phusanti, Sithakom, Nanthatanti, Nithita, Suwannalert, Prasit, Sibmooh, Nathawut
• Format: Article
• Language: English
• Subjects: Adenosine diphosphate; Adenosine triphosphatase; Aggregates; Analysis; Bacterial pneumonia; Biology and Life Sciences; Blood Platelets - metabolism; Care and treatment; Cell activation; Cell number; Correlation; COVID-19; COVID-19 - metabolism; Development and progression; Flow Cytometry; Glycoproteins; Humans; Interleukin 6; Kinases; L-Lactate dehydrogenase; Lactate dehydrogenase; Lactic acid; Leukocytes; Leukocytes (neutrophilic); Lymphocytes; Medicine and Health Sciences; Monocytes; Monocytes - metabolism; P-selectin; P-Selectin - metabolism; Physical Sciences; Platelet Activation; Platelet Aggregation; Platelet Glycoprotein GPIIb-IIIa Complex - metabolism; Platelets; Pneumonia; Thromboembolism; Thrombosis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0282785

The increased procoagulant platelets and platelet activation are associated with thrombosis in COVID-19. In this study, we investigated platelet activation in COVID-19 patients and their association with other disease markers. COVID-19 patients were classified into three severity groups: no pneumonia, mild-to-moderate pneumonia, and severe pneumonia. The expression of P-selectin and activated glycoprotein (aGP) IIb/IIIa on the platelet surface and platelet-leukocyte aggregates were measured prospectively on admission days 1, 7, and 10 by flow cytometry. P-selectin expression, platelet-neutrophil, platelet-lymphocyte, and platelet-monocyte aggregates were higher in COVID-19 patients than in uninfected control individuals. In contrast, aGPIIb/IIIa expression was not different between patients and controls. Severe pneumonia patients had lower platelet-monocyte aggregates than patients without pneumonia and patients with mild-to-moderate pneumonia. Platelet-neutrophil and platelet-lymphocyte aggregates were not different among groups. There was no change in platelet-leukocyte aggregates and P-selectin expression on days 1, 7, and 10. aGPIIb/IIIa expression was not different among patient groups. Still, adenosine diphosphate (ADP)-induced aGPIIb/IIIa expression was lower in severe pneumonia than in patients without and with mild-to-moderate pneumonia. Platelet-monocyte aggregates exhibited a weak positive correlation with lymphocyte count and weak negative correlations with interleukin-6, D-dimer, lactate dehydrogenase, and nitrite. COVID-19 patients have higher platelet-leukocyte aggregates and P-selectin expression than controls, indicating increased platelet activation. Compared within patient groups, platelet-monocyte aggregates were lower in severe pneumonia patients.