PMC:7271924 / 22359-24331 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7271924","sourcedb":"PMC","sourceid":"7271924","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7271924","text":"Of particular interest, and in the context of this paper, is the set of interactions between SARS-CoV-2 and host platelets. This is of importance, as COVID-19 infection, can cause hyperinflammation due to a cytokine storm (166). Pathogens like the influenza virus and Francisella tularensis, do trigger life-threatening cytokine storms (173). Such a cytokine storm will significantly affect platelets, as platelets have many receptors where these inflammatory molecules may bind (173) (see Figure 5). Circulating cytokines and inflammagens will hyperactivate platelets, causing low platelet count (thrombocytopenia), and a significant chance of hypercoagulation. Thrombocytopenia is associated with increased risk of severe disease and mortality in patients with COVID-19, and thus serves as clinical indicator of worsening illness during hospitalization (174, 175). Patients with type 2 diabetes are also particularly prone to increased levels of circulating inflammatory cytokines and hypercoagulation (76). COVID-19 patients without other comorbidities but with diabetes are at higher risk of severe pneumonia, excessive uncontrolled inflammatory responses and a hypercoagulable state (176). Guo and co-workers in 2020 also found that serum levels of IL-6, C-reactive protein, serum ferritin, and D-dimer, were significantly higher in diabetic patients compared with those without, suggesting that patients with diabetes are more susceptible to an inflammatory storm eventually leading to rapid deterioration of the patient with COVID-19 (140). Acute pulmonary embolism has also been reported in COVID-19 infection (177). Focal accumulation of activated platelets within the oedematous area ex vivo correlated well with the size of the pulmonary embolism (178). Interestingly, anticoagulant therapy, mainly with (intravenous) heparin (and mainly with low molecular weight heparin, LMWH), appears to be associated with better prognosis in severe COVID-19 patients 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