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Updated: Oct 10, 2025
Analyzing Platelet Subpopulations by Multi-color Flow Cytometry
Published on: June 10, 2025
Massive image-based single-cell profiling reveals high levels of circulating platelet aggregates in patients with
Masako Nishikawa1, Hiroshi Kanno2, Yuqi Zhou2
1Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan.
Insights
COVID-19 patients frequently exhibit microvascular thrombosis. This study found excessive circulating platelet aggregates in nearly 90% of patients, linked to disease severity and mortality.
Area of Science:
- Cardiovascular Biology
- Hematology
- Infectious Diseases
Background:
- COVID-19 is characterized by frequent microvascular thrombosis, leading to multiorgan failure.
- Autopsy reports reveal widespread thrombotic microangiopathy in COVID-19 patients.
- The precise mechanisms driving COVID-19-associated microvascular thrombosis are not fully understood.
Purpose of the Study:
- To investigate the landscape of circulating platelet aggregates in COVID-19 patients.
- To identify potential diagnostic or prognostic markers for COVID-19 severity.
Main Methods:
- Massive single-cell image-based profiling was employed.
- Temporal monitoring of blood samples from 110 COVID-19 patients was conducted.
- Analysis focused on quantifying platelet aggregation.
Main Results:
- Anomalous presence of excessive platelet aggregates was observed in approximately 90% of COVID-19 patients.
- A strong correlation was found between platelet aggregate concentration and COVID-19 severity.
- Platelet aggregate levels were linked to mortality, respiratory status, and vascular endothelial dysfunction.
Conclusions:
- Excessive circulating platelet aggregates are a significant finding in COVID-19 patients.
- Platelet aggregation may serve as a key indicator of COVID-19 severity and patient outcomes.
- Further research into targeting platelet aggregation could offer therapeutic strategies.
Abstract:
A characteristic clinical feature of COVID-19 is the frequent incidence of microvascular thrombosis. In fact, COVID-19 autopsy reports have shown widespread thrombotic microangiopathy characterized by extensive diffuse microthrombi within peripheral capillaries and arterioles in lungs, hearts, and other organs, resulting in multiorgan failure. However, the underlying process of COVID-19-associated microvascular thrombosis remains elusive due to the lack of tools to statistically examine platelet aggregation (i.e., the initiation of microthrombus formation) in detail. Here we report the landscape of circulating platelet aggregates in COVID-19 obtained by massive single-cell image-based profiling and temporal monitoring of the blood of COVID-19 patients (n = 110). Surprisingly, our analysis of the big image data shows the anomalous presence of excessive platelet aggregates in nearly 90% of all COVID-19 patients. Furthermore, results indicate strong links between the concentration of platelet aggregates and the severity, mortality, respiratory condition, and vascular endothelial dysfunction level of COVID-19 patients.
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