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Platelet Aggregation Alterations in Patients with Severe Viral Infection Treated at the Intensive Care Unit:
Wojciech Bakowski1, Jakub Smiechowicz1, Barbara Dragan1
1Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
Pathogens (Basel, Switzerland)
|September 28, 2024
Summary
Platelet aggregation is impaired in patients with severe viral infections like SARS-CoV-2, indicating a higher mortality risk. This finding suggests aggregometry can help identify at-risk patients early.
Area of Science:
- Hematology
- Virology
- Critical Care Medicine
Background:
- Severe viral infections disrupt hemostasis, initially causing platelet hyperactivation.
- Platelet exhaustion and hypo-responsiveness follow, impairing function.
- Early platelet dysfunction is critical in acute respiratory distress syndrome (ARDS).
Purpose of the Study:
- To investigate early alterations in platelet aggregation in ARDS patients with SARS-CoV-2.
- To assess the relationship between platelet aggregation and mortality in this cohort.
Main Methods:
- Studied 28 mechanically ventilated ARDS patients with SARS-CoV-2 on ECMO support.
- Analyzed blood samples using four platelet activators: arachidonic acid, ADP, TRAP-6, and ristocetin.
- Monitored platelet aggregation and coagulation parameters over 5 days.
Main Results:
- Reduced platelet aggregation observed in most patients upon admission (61-89% reduction).
- Platelet aggregation further decreased during the observation period.
- Impaired aggregation strongly correlated with increased patient mortality (p=0.028).
Conclusions:
- Platelet aggregation is significantly reduced in severe SARS-CoV-2 ARDS patients.
- Impaired platelet aggregation is a predictor of mortality in this population.
- Aggregometry may serve as an early diagnostic tool for risk stratification.
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