Frontiers in Immunology (May 2023)

Platelet-neutrophil interaction in COVID-19 and vaccine-induced thrombotic thrombocytopenia

  • Johannes Hirsch,
  • Johannes Hirsch,
  • Günalp Uzun,
  • Günalp Uzun,
  • Jan Zlamal,
  • Jan Zlamal,
  • Anurag Singh,
  • Tamam Bakchoul,
  • Tamam Bakchoul

DOI
https://doi.org/10.3389/fimmu.2023.1186000
Journal volume & issue
Vol. 14

Abstract

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Coronavirus disease 2019 (COVID-19) is known to commonly induce a thrombotic diathesis, particularly in severely affected individuals. So far, this COVID-19-associated coagulopathy (CAC) has been partially explained by hyperactivated platelets as well as by the prothrombotic effects of neutrophil extracellular traps (NETs) released from neutrophils. However, precise insight into the bidirectional relationship between platelets and neutrophils in the pathophysiology of CAC still lags behind. Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare autoimmune disorder caused by auto-antibody formation in response to immunization with adenoviral vector vaccines. VITT is associated with life-threatening thromboembolic events and thus, high fatality rates. Our concept of the thrombophilia observed in VITT is relatively new, hence a better understanding could help in the management of such patients with the potential to also prevent VITT. In this review we aim to summarize the current knowledge on platelet-neutrophil interplay in COVID-19 and VITT.

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