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Evidence of SARS-CoV-2 spike protein on retrieved thrombi from COVID-19 patients
Manuela De Michele1, Giulia d'Amati2, Martina Leopizzi3
1Emergency Department, Stroke Unit, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy. m.demichele@policlinicoumberto1.it.
Abstract:
The pathophysiology of COVID-19-associated coagulopathy is complex and not fully understood. SARS-CoV-2 spike protein (SP) may activate platelets and interact with fibrin(ogen). We aimed to investigate whether isolated SP can be present in clots retrieved in COVID-19 patients with acute ischemic stroke (by mechanical thrombectomy) and myocardial infarction. In this pilot study, we could detect SP, but not nucleocapsid protein, on platelets of COVID-19 patients' thrombi. In addition, in all three COVID-19 thrombi analyzed for molecular biology, no SARS-CoV-2 RNA could be detected by real-time polymerase chain reaction. These data could support the hypothesis that free SP, besides the whole virus, may be the trigger of platelet activation and clot formation in COVID-19.

