The role of platelets, neutrophils and endothelium in COVID-19 infection. Issue 8 (3rd August 2022)

• Record Type: Journal Article
• Authors: Falcinelli, E.; Petito, E.; Gresele, P.
• Is Part Of: Expert review of hematology. Volume 15:Issue 8(2022)
• Page Start: 727
• Page End: 745
• Publication Date: 2022-08-03
• Subjects: Antithrombotic therapy -- COVID-19 -- cytokines -- endothelial cells -- extracellular microvescicles -- neutrophils -- platelets -- SARS-CoV-2 -- thromboinflammation; Hematology -- Periodicals; 616.15005
• DOI: 10.1080/17474086.2022.2110061
• Languages: English
• ISSNs: 1747-4086

Abstract

ABSTRACT: Introduction: COVID-19 is associated to an increased risk of thrombosis, as a result of a complex process that involves the activation of vascular and circulating cells, the release of soluble inflammatory and thrombotic mediators and blood clotting activation. Areas covered: This article reviews the pathophysiological role of platelets, neutrophils, and the endothelium, and of their interactions, in the thrombotic complications of COVID-19 patients, and the current and future therapeutic approaches targeting these cell types. Expert opinion: Virus-induced platelet, neutrophil, and endothelial cell changes are crucial triggers of the thrombotic complications and of the adverse evolution of COVID-19. Both the direct interaction with the virus and the associated cytokine storm concur to trigger cell activation in a classical thromboinflammatory vicious circle. Although heparin has proven to be an effective prophylactic and therapeutic weapon for the prevention and treatment of COVID-19-associated thrombosis, it acts downstream of the cascade of events triggered by SARS-CoV-2. The identification of specific molecular targets interrupting the thromboinflammatory cascade upstream, and more specifically acting either on the interaction of SARS-CoV-2 with blood and vascular cells or on the specific signaling mechanisms associated with their COVID-19-associated activation, might theoretically offer greater protection with potentially lesser side effects.