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- Title
Elevated P-Selectin in Severe Covid-19: Considerations for Therapeutic Options.
- Authors
Agrati, Chiara; Bordoni, Veronica; Sacchi, Alessandra; Petrosillo, Nicola; Nicastri, Emanuele; Del Nonno, Franca; D'Offizi, Gianpiero; Palmieri, Fabrizio; Marchioni, Luisa; Capobianchi, Maria Rosaria; Antinori, Andrea; Ippolito, Giuseppe; Bibas, Michele
- Abstract
Background: Coronavirus disease 2019 (COVID-19) is mainly a respiratory tract disease and acute respiratory failure with diffuse microvascular pulmonary thrombosis are critical aspects of the morbidity and mortality of this new syndrome. Purpose: The aim of our study was to investigate, in severe COVID-19 hospitalized patients, the P-selectin plasma concentration as a biomarker of endothelial dysfunction and platelet activation. Methods: 46 patients with severe or critical SARS-CoV-2 infection were included in the study. Age-matched patients then were divided in those requiring admission to the intensive care unit (ICU, ICU cases) vs those not requiring ICU hospitalization (non-ICU cases). Blood samples of severe COVID-19 patients were collected at the time of hospital admission. The quantification of soluble P-selectin was performed by ELI, assay. Results: Our study showed a higher P-selectin plasma concentration in patients with Covid-19, regardless of ICU admission, compared to the normal reference values and compared to ten contextually sampled healthy donors (HD); (COVID-19): median 65.2 (IQRs: 45.1-81.1) vs. HD: 40.3 (IQRs: 24.3-48.7), p=0023. Moreover, results showed a significant reduction of P-sele din after platelets removal in HD, in contrast, both ICU and non-ICU COVID-19 patients showed similar high levels of P-selectin with and without platelets. Conclusion: Elevation of P-selectin suggests a central role of platelet endothelium interaction as part of the multifaced pathogenic mechanism of COVID-19 leading to the local activation of hemostatic system forming pulmonary thrombi. Further work is necessary to determine the therapeutic role of antiplatelets agents or of the anti P-selectin antibody Crizanlizumab.
- Subjects
RESPIRATORY diseases; ENDOTHELIUM diseases; COVID-19; ADULT respiratory distress syndrome; INTENSIVE care units; BLOOD platelet activation
- Publication
Mediterranean Journal of Hematology & Infectious Diseases, 2021, Vol 13, Issue 1, p1
- ISSN
2035-3006
- Publication type
Article
- DOI
10.4084/MJHID.2021.016