Известия высших учебных заведений. Поволжский регион: Медицинские науки (Dec 2023)

Pathogenetic significance of large forms of platelets in complication of COVID-19

  • N.I. Mikulyak,
  • I.A. Sorokin,
  • L.A. Sorokina,
  • A.S. Kinzirskiy,
  • E.D. Kostrigina

DOI
https://doi.org/10.21685/2072-3032-2023-3-21
Journal volume & issue
no. 3

Abstract

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Background. The presence of large platelets in the pulmonary vessels was first reported by Aschoff as early as 1893. Somewhat later it was discovered that up to half of the entire blood platelet pool could be formed by thrombopoietic cells deposited in the pulmonary capillaries. Because of the nature of the cytokine storm in COVID-19, pulmonary platelets may play a significant role in the development of fatal thromboembolic complications. In addition, there are a large number of clinical conditions in which large platelets are also found. Young large platelets contain a large number of granules with cytokines such as RANTES, IL-1β, etc., which contribute to the release of other pro-inflammatory cytokines that stimulate even more platelet synthesis. The purpose of the study is to compare changes in platelet indices in patients who died and died from coronavirus infection. Materials and methods. 149 results of platelet indices of the general blood count were analysed in 94 patients with identified coronavirus infection. The results were divided into 3 groups: those who died of COVID-19, those who did not die of COVID-19 of the same, older age and those who did not die of COVID-19 of younger age. The following platelet indices were considered: PLT, MPV, PDW, P-LCR. Results and conclusions. The deceased patients (70,6 ± 11,4 years old) had lower platelet count (p<0,01) and higher PDW, P-LCR indices (p<0,05) compared to the patients who didn't die from COVID-19, which indicates both percentage and absolute increase of the large platelet fraction. In the study, we looked at changes in several platelet indices: PLT, MPV, PDW, P-LCR in patients with COVID- 19. Deceased patients (70.6 ± 11.4 years) showed decreased platelet count (p<0.01) and increased PDW, P-LCR indices, compared to patients who did not die from COVID-19. Conclusions. The presence of macrothrombocytes in deceased patients indicates their increase over time, providing an opportunity for its timely screening and predicting the development of thromboembolic complications pro COVID-19.

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