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COVID-19: ‘Hyperactivity’ in Coagulation Cells

Robert A. Campbell, a senior author and assistant professor in the Department of Internal Medicine explains,

"We found that inflammation and systemic changes, due to the infection, are influencing how platelets function, leading them to aggregate faster, which could explain why we are seeing increased numbers of blood clots in COVID patients."

COVID-19 began to emerge late in 2019 as an unknown harmful acute respiratory illness that was quickly found to be dangerously contagious with symptoms like fever, cough, sore throat, headaches, muscle aches, and fatigue. The target organ that COVID-19 attacks is the lungs, which can lead patients to develop lung complications that progress to respiratory failure and possibly multi-organ failure.


As the rates of blood clots in patients are staggering exponentially, doctors are noticing the prevalence of these thrombotic factors. As this was noted, they began thorough research through autopsies of COVID-19 patients who had recently died and found that the rate of risk for thrombosis is increasingly high with COVID-19. Beverley Hunt, medical director and clinician of Thrombosis UK, explains that COVID-19 is responsible for the inflammation boosting cytokines that affect the important clotting factors from the liver; making an infected patient's blood extremely sticky.


A short video by ABC News explains the complications of the virus itself and what happens to patients -- in particular, Broadway actor and Tony nominee Nick Cordero. He had to have his leg amputated due to extreme blood clotting and now remains hospitalized.


In early May 2020, there were several clinical studies done at the National Hospital for Neurology and Neurosurgery, London because it was thought that COVID-19 caused clots to form in the brains of patients who had suffered a stroke. This specific finding allowed for an early investigation of a protein fragment found in the blood in rapid blood clotting called a D-dimer. This, in turn, allowed for earlier treatment by clinicians for anticoagulants that might have reduced the number of strokes seen in COVID-19 patients.


The overall findings in a recent research article in the Journal of Neurology, Neurosurgery, and Psychiatry support the evidence that COVID-19 patients show abnormal blood coagulation, increased D-dimer and production of antiphospholipid antibodies usually caused by an immune system disorder. There is also evidence through autopsies of COVID-19 patients showing that there is a relationship between this virus and blood coagulation, which may result in higher rates of possible cardiovascular problems - something as fatal as a pulmonary embolism, organ failure or other serious health complications.


CT scans of brain images of an acute ischaemic stroke. (Jacob F Quail via Medpix)


Another study that was conducted by the University of Utah Hospital in Salt Lake City took on 41 patients with COVID-19. The blood of these patients compared to healthy individuals were drawn and matched for criteria of age and sex. The researchers used differential gene analysis - taking the data and performing statistical analysis tests on them to characterize any quantitative changes in levels of expression. They found that COVID-19 seems to trigger extensive genetic variations in the platelets in the blood, and that these platelets' interactions with the immune system are modified, making them "hyperactive" and more prone to form harmful blood clots in the body.


COVID-19 shows to trigger hyperactivity in platelets of infected patients leading to the formation of more blood clots (Getty Images)


Dr. Campbell and his colleagues determined through extensive studies that introducing aspirin to infected patients platelets in experimental test tubes indicated the prevention of hyperactivity in the platelets. These findings possibly suggest aspirin may come into play in the future and help improve the clotting problems of infected patients but there is not sufficient evidence or clinical trials to confirm this. Dr. Campbell warns against using aspirin at home to treat COVID-19 unless it is recommended by your primary care physician. Further studies and clinical trials are still ongoing at this time.


Article Contributors: Minuki Wickramasuriya, Valerie Shirobokov

References:


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Featured image courtesy of Cardiology Magazine


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