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Circulating Extracellular Vesicle Levels in Patients with Coronavirus Disease 2019 Coagulopathy: A Prospective Cohort
Yudai Iwasaki1, Yusuke Takei1, Mitsuhiro Yamada2
1Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan.
Insights
Extracellular vesicle (EV) levels were investigated in COVID-19 coagulopathy. CD41+ EVs were significantly higher in COVID-19 coagulopathy patients compared to healthy volunteers, suggesting their role in disease development.
Area of Science:
- Hematology
- Immunology
- Pathophysiology
Background:
- Coronavirus disease 2019 (COVID-19) is linked to coagulopathy, but mechanisms remain unclear.
- Extracellular vesicles (EVs) are implicated in various pathological processes, including thrombosis.
Purpose of the Study:
- To investigate the association between COVID-19 coagulopathy and extracellular vesicle (EV) levels.
- To determine if specific EV subtypes are elevated in COVID-19 patients with coagulopathy.
Main Methods:
- Prospective observational study involving 99 hospitalized COVID-19 patients (48 with coagulopathy, 51 without) and 10 healthy volunteers.
- Patients were categorized by D-dimer levels (≥1 μg/mL for coagulopathy, <1 μg/mL for non-coagulopathy).
- Flow cytometry was used to quantify various EV subtypes in platelet-free plasma.
Main Results:
- No significant differences in overall EV levels were observed between COVID-19 coagulopathy and non-coagulopathy groups.
- However, CD41+ (platelet-derived) EV levels were significantly elevated in COVID-19 coagulopathy patients compared to healthy volunteers (p=0.011).
Conclusions:
- While overall EV levels did not differentiate COVID-19 coagulopathy, elevated CD41+ EVs suggest a potential role in the development of coagulopathy in COVID-19.
- Further research is warranted to elucidate the specific mechanisms by which CD41+ EVs contribute to COVID-19-associated coagulopathy.
Abstract:
Coronavirus disease 2019 (COVID-19) is associated with coagulopathy. However, the underlying mechanisms are not completely understood. We evaluated the association between COVID-19 coagulopathy and extracellular vesicle (EV) levels. We hypothesized that several EV levels would be higher in COVID-19 coagulopathy patients than in non-coagulopathy patients. This prospective observational study was conducted in four tertiary care faculties in Japan. We enrolled 99 COVID-19 patients (48 with coagulopathy and 51 without coagulopathy) aged ≥20 years who required hospitalization, and 10 healthy volunteers; we divided the patients into coagulopathy and non-coagulopathy groups according to the D-dimer levels (≥1 μg/mL and <1 μg/mL, respectively). We used flow cytometry to measure the tissue-factor-bearing, endothelium-derived, platelet-derived, monocyte-derived, and neutrophil-derived EV levels in platelet-free plasma. The EV levels were compared between the two COVID-19 groups as well as among the coagulopathy patients, non-coagulopathy patients, and healthy volunteers. No significant difference was found in EV levels between the two groups. Meanwhile, the cluster of differentiation (CD) 41 + EV levels were significantly higher in COVID-19 coagulopathy patients than in healthy volunteers (549.90 [255.05-984.65] vs. 184.3 [150.1-254.1] counts/µL, p = 0.011). Therefore, CD41+ EVs might play an essential role in COVID-19 coagulopathy development.
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