Platelets and renal failure in the SARS-CoV-2 syndrome.
Platelets and renal failure in the SARS-CoV-2 syndrome.
复制标题
SARS-CoV-2 综合征中的血小板和肾衰竭。
DOI：
10.1080/09537104.2020.1817361
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发表时间：
2021-01-02
期刊：
影响因子：
3.3
通讯作者：
Samavati L
中科院分区：
文献类型：
--
作者：
Taha M;Sano D;Hanoudi S;Esber Z;Elahi M;Gabali A;Chopra T;Draghici S;Samavati L
冠状病毒病19(新冠肺炎)是由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的一种高度传染性的病毒感染。SARS-CoV-2利用金属羧基肽酶血管紧张素受体(ACE)2进入人体细胞。几种蛋白酶的激活促进了病毒刺突蛋白(S1)与ACE2受体的相互作用。这会导致宿主ACE2受体的裂解。血管紧张素转换酶2的活性抵消了血管紧张素II的作用，它的缺失可能通过调节血小板的功能、大小和活性而导致血管紧张素II水平升高。新冠肺炎病涉及的全身性疾病远远不止是呼吸衰竭。这种疾病的几个特征，包括急性肾损伤(AKI)的病因和高凝状态，仍然知之甚少。在此，我们发现，在D-二聚体、铁蛋白、C反应蛋白和乳酸脱氢酶水平升高的新冠肺炎危重患者中，急性心肌梗死的发生率很高(81%)。值得注意的是，这些患者的血小板有独特的特征，包括更大、更多的颗粒状血小板和更高的平均血小板体积(MPV)。在危重病队列中，D-二聚体水平与MVP显著相关，而MPV与肾小球滤过率(GFR)呈负相关。我们的数据表明，活化的血小板可能在COVID19患者的肾功能衰竭和可能的高凝状态中发挥作用。
The coronavirus disease 19 (COVID-19) is a highly transmittable viral infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS‐CoV‐2 utilizes metallocarboxyl peptidase angiotensin receptor (ACE) 2 to gain entry into human cells. Activation of several proteases facilitates the interaction of viral spike proteins (S1) and ACE2 receptor. This leads to cleavage of host ACE2 receptors. ACE2 activity counterbalances the angiotensin II effect, its loss may lead to elevated angiotensin II levels with modulation of platelet function, size and activity. COVID-19 disease encompasses a spectrum of systemic involvement far beyond respiratory failure alone. Several features of this disease, including the etiology of acute kidney injury (AKI) and the hypercoagulable state, remain poorly understood. Here, we show that there is a high incidence of AKI (81%) in the critically ill adults with COVID-19 in the setting of elevated D-dimer, elevated ferritin, C reactive protein (CRP) and lactate dehydrogenase (LDH) levels. Strikingly, there were unique features of platelets in these patients, including larger, more granular platelets and a higher mean platelet volume (MPV). There was a significant correlation between measured D-dimer levels and MVP; but a negative correlation between MPV and glomerular filtration rates (GFR) in critically ill cohort. Our data suggests that activated platelets may play a role in renal failure and possibly hypercoagulability status in COVID19 patients.
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影响因子：
64.8
作者：
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