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Platelets and renal failure in the SARS-CoV-2 syndrome
Muhanad Taha1, Dahlia Sano2, Samer Hanoudi3
1Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University, School of Medicine and Detroit Medical Center , Detroit, MI, USA.
Platelets
|September 7, 2020
Summary
Activated platelets may contribute to kidney injury and hypercoagulability in critically ill patients with COVID-19. This study found high rates of acute kidney injury (AKI) and unique platelet characteristics in these patients.
Area of Science:
- Nephrology
- Hematology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, involves systemic complications beyond respiratory failure.
- The mechanisms of acute kidney injury (AKI) and hypercoagulable states in COVID-19 are not fully understood.
- SARS-CoV-2 entry into human cells involves the ACE2 receptor, and its cleavage impacts angiotensin II levels and platelet function.
Purpose of the Study:
- To investigate the incidence of AKI in critically ill COVID-19 patients.
- To examine platelet characteristics and their correlation with renal function and coagulation markers.
- To explore the potential role of platelets in COVID-19-associated renal failure and hypercoagulability.
Main Methods:
- Retrospective analysis of critically ill adult COVID-19 patients.
- Measurement of laboratory markers including D-dimer, ferritin, CRP, LDH, and MPV.
- Assessment of glomerular filtration rates (GFR).
Main Results:
- High incidence of AKI (81%) observed in critically ill COVID-19 patients.
- Elevated D-dimer, ferritin, CRP, and LDH levels were common.
- Patients exhibited unique platelet features: larger, more granular platelets with higher MPV.
- Significant correlation found between D-dimer and MPV; negative correlation between MPV and GFR.
Conclusions:
- Activated platelets may play a significant role in the pathogenesis of AKI in COVID-19.
- Platelet activation and altered characteristics could contribute to the hypercoagulable state observed in COVID-19 patients.
- Further research is warranted to elucidate the precise mechanisms linking platelets, renal function, and coagulation in COVID-19.
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