• Filippo Consolo, Della VallePatriziaPUnit of Coagulation Service and Thrombosis Research, IRCCS San Raffaele Hospital, Milan, Italy., Marco Saracino, Marta Bonora, Giovanni Donadoni, Fabio Ciceri, Moreno Tresoldi, Armando D'Angelo, Giovanni Landoni, and Alberto Zangrillo.
• Vita-Salute San Raffaele University, Milan, Italy - consolo.filippo@unisr.it.
• Minerva Anestesiol. 2022 Jun 1; 88 (6): 472-478.

BackgroundPlatelet activation at the early stage of COVID-19 is poorly described. The need for antiplatelet therapy in patients with COVID-19 remains controversial. We characterized the platelet activation profile in hospitalized patients at the early stage of COVID-19 using the modified prothrombinase Platelet Activation State (PAS) Assay.MethodsSixteen patients admitted to the emergency department of the IRCCS San Raffaele Hospital (Milan, Italy) between February 8 and April 2021 were enrolled. All patients presented with respiratory symptoms and tested positive for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Platelet activation was measured via the PAS Assay within 24 hours from patients' hospital admission. Data were compared with those measured in N.=24 healthy subjects (controls).ResultsPlatelet activation was significantly higher in COVID-19 patients with respect to controls (PAS=0.63 [0.58-0.98%] vs. 0.46 [0.40-0.65%], respectively; P=0.03). Of note, highest PAS values were measured in the two patients with the worst clinical outcome, i.e., death because of respiratory failure (PAS=2.09% and 1.20%, respectively). No differences in standard coagulation parameters were noted between these two patients and those who were later discharged home.ConclusionsThis study provides evidence of significant platelet activation state at the early stage of COVID-19 and suggests that the patient-specific platelet activation profile is a reliable clinical marker to stratify COVID-19 patients at high risk of poor clinical outcome who might potentially benefit from antiplatelet therapy.

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