Platelets and SARS-CoV-2 During COVID-19: Immunity, Thrombosis, and Beyond

2023/05/11 by Anthony Sciaudone, Anthony R. Sciaudone, Heather A. Corkrey +3 · 58 citations
Medicine · #Biochemistry #Biology #COVID-19 Clinical Research Studies #Coagulation #Dermatological and COVID-19 studies #Gene #Immune system #Immunology #Inflammation #Internal medicine #Medicine #Microvesicles #Neutrophil extracellular traps #Platelet #Platelet Disorders and Treatments #Platelet activation #Thrombosis #Virology

paper · open access · doi:10.1161/circresaha.122.321930

published in Circulation Research 132(10), 1272-1289 (Lippincott Williams & Wilkins)

openalex publication_date 2023/05/11 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

Abstract

COVID-19 is characterized by dysregulated thrombosis and coagulation that can increase mortality in patients. Platelets are fast responders to pathogen presence, alerting the surrounding immune cells and contributing to thrombosis and intravascular coagulation. The SARS-CoV-2 genome has been found in platelets from patients with COVID-19, and its coverage varies according to the method of detection, suggesting direct interaction of the virus with these cells. Antibodies against Spike and Nucleocapsid have confirmed this platelet-viral interaction. This review discusses the immune, prothrombotic, and procoagulant characteristics of platelets observed in patients with COVID-19. We outline the direct and indirect interaction of platelets with SARS-CoV-2, the contribution of the virus to programmed cell death pathway activation in platelets and the consequent extracellular vesicle release. We discuss platelet activation and immunothrombosis in patients with COVID-19, the effect of Spike on platelets, and possible activation of platelets by classical platelet activation triggers as well as contribution of platelets to complement activation. As COVID-19-mediated thrombosis and coagulation are still not well understood in vivo, we discuss available murine models and mouse adaptable strains.

Citations

• Circulating Platelets as Mediators of Immunity, Inflammation, and Thrombosis
• Platelets Can Associate With SARS-CoV-2 RNA and Are Hyperactivated in COVID-19
• SARS-CoV-2 Initiates Programmed Cell Death in Platelets
• Platelet and Megakaryocyte Roles in Innate and Adaptive Immunity

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