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Von Willebrand factor with increased binding capacity is associated with reduced platelet aggregation but enhanced agglutination in COVID-19 patients: another COVID-19 paradox?

2021; Springer Science+Business Media; Volume: 52; Issue: 1 Linguagem: Inglês

10.1007/s11239-020-02339-6

1573-742X

Franco Ruberto, Antonio Chistolini, Mariaignazia Curreli, Giacomo Frati, Antonino Marullo, Giuseppe Biondi‐Zoccai, Massimo Mancone, Sebastiano Sciarretta, Fabio Miraldi, Francesco Alessandri, Giancarlo Ceccarelli, F. Barone, Cristina Santoro, Domenico Alvaro, Francesco Pugliese, Fabio M. Pulcinelli, Alida Albante, Francesco Alessandri, Domenico Alvaro, Guido Antonelli, Fabio Araimo-Morselli, Daniela Auricchio, F. Barone, Federico Bilotta, Giuseppe Biondi-Zoccai Matteo Brisciani, Katia Bruno, Alessandro Cappannoli, Vincenzo Cardinale, Giancarlo Ceccarelli, Paola Celli, Antonio Chistolini, Stella Consolo, Claudia Croce, Beatrice Crocitti, Mariaignazia Curreli, Gabriella d’Ettorre, Lauri De Daniela, Francesco De Lazzaro, Francesco Fedele, Giacomo Frati, Gioacchino Galardo, Lorena Giannetti, S. Ianni, Carmela Imperiale, Viviana Maestrini, Eugenia Magnanimi, Federica Maldarelli, Massimo Mancone, S. Martelli, Antonino Marullo, Claudio Maria Mastroianni, Teresa Messina, Fabio Miraldi, Elisa Pattelli, Filippo Pecorari, Serena Perrella, Mario Piazzolla, Monica Portieri, Francesco Pugliese, Fabio M. Pulcinelli, Fabiola Ratini, Claudia Ricci, Franco Ruberto, Pietro Santopietro, Guglielmo Tellan, Luca Titi, Paolo Tordiglione, Antonella Tosi, Fausto Trigilia, Cristina Santoro, Sebastiano Sciarretta,

Blood groups and transfusion

Patients with Coronavirus-associated disease-2019 (COVID-19) display alterations of the hemostatic system and the presence of a prothrombotic status frequently leading to vascular complications. However, the impact of COVID-19 on platelet activity, aggregation and agglutination still needs to be clarified. We measured total levels of von Willebrand factor (vWF) and vWF binding to the platelet glycoprotein (Gp) complex (GPIb-IX-V), in a cohort of COVID-19 patients admitted to the intensive care unit of our Institution. Moreover, we evaluated platelet aggregation in response to agonists (ADP, collagen, arachidonic acid) and platelet agglutination in response to ristocetin. We found that levels of vWF antigen and the active form of vWF binding to platelets (vWF:RCo), were markedly increased in these patients. These results were associated with higher agglutination rates induced by ristocetin, thereby indirectly indicating an increased capability of vWF to bind to platelets. Conversely, we found that platelet aggregation in response to both ADP and collagen was lower in COVID-19 patients compared to healthy volunteers. This study shows that COVID-19 is associated with increased vWF-induced platelet agglutination but reduced platelet responsivity to aggregation stimuli. Our findings have translational relevance since platelet adhesion to vWF may represent a marker to predict possible complications and better delineate therapeutic strategies in COVID-19 patients.