“Ultrastructural changes of platelets in COVID-19 and chronic viral hepatitis patients “

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Mohamed Hassan A.S.; Abo Gaziah S.S.A.; Ezzelregal Awad H.G.; Hegab Abdelhady S.M.; Talaat Elkhafif N.A.; Hassan Mostafa N.B.

Journal: Ultrastructural Pathology

Publisher: Taylor and Francis Ltd.

Publication Date: 15 April 2024

Volume / Issue: Volume 48 / Issue 3

Pages: 234–245

ISSN: 1913123

DOI: 10.1080/01913123.2024.2342437

Scopus: View on Scopus

PubMed: 38619195

Document Type: Article

Authors and Affiliations

Mohamed Hassan A.S., Department of Electron Microscopy, Theodore Bilharz Research Institute, Giza, Egypt; Abo Gaziah S.S.A., Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Ezzelregal Awad H.G., Chest Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Hegab Abdelhady S.M., Department of Electron Microscopy, Theodore Bilharz Research Institute, Giza, Egypt; Talaat Elkhafif N.A., Department of Electron Microscopy, Theodore Bilharz Research Institute, Giza, Egypt; Hassan Mostafa N.B., Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Platelet-viral interactions are evolving as a new concern. Coagulation disorder is a major consequence of the COVID-19 infection. In chronic hepatitis virus infections, defect in coagulation factors, thrombocytopenia and platelet function abnormalities are common. A SARS-CoV-2 infection on top of chronic viral hepatitis infection can be common in areas where viral hepatitis is endemic. Here, we investigate the platelet ultrastructural changes and estimate the serum platelet factor-4 (PF-4), ferritin, CRP, and D-dimer in COVID-19 patients (n = 60), COVID-19 patients with associated chronic viral hepatitis (n = 20), and healthy subjects (n = 20). Ultrastructural changes were demonstrated in all test groups, denoting platelet activation. In chronic viral hepatitis patients, Platelet ultrastrustural apoptotic changes were also seen. Significantly high levels of PF-4 were confirmed in moderate and severe COVID-19 patients (P.value <0.001), with a cut off value of 17 ng/ml for predicting disease severity. A positive correlation of PF-4 with the level of serum ferritin, CRP, and D-dimer (p value < 0.001) was noted, while negatively correlated with platelet count and platelet granule count (p value < 0.001). In our study, chronic viral hepatitis patients presented mild COVID-19 signs, and their PF-4 level was comparable with the subgroup of mild COVID-19 infection. The platelet’s critical role in COVID-19 coagulopathy and chronic viral hepatitis is evidenced by the ultrastructural changes and the high levels of PF4. Moreover, a dual viral infection poses a substantial burden on the platelets, necessitating close monitoring of the patient’s coagulation profile. © 2024 Taylor & Francis Group, LLC.

Keywords

Chronic viral hepatitis; COVID-19; Platelets activation; Adult; Aged; Blood Platelets; Female; Fibrin Fibrinogen Degradation Products; Hepatitis C, Chronic; Humans; Male; Middle Aged; Platelet Activation; Platelet Count; Platelet Factor 4; SARS-CoV-2; fibrin degradation product; fibrin fragment D; thrombocyte factor 4; blood; chronic hepatitis C; complication; coronavirus disease 2019; human; pathology; Severe acute respiratory syndrome coronavirus 2; thrombocyte; thrombocyte activation; ultrastructure

Citation Information

Scopus Citations: 1

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