Platelet apoptosis markers under anticoagulation for COVID-19 infection

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OBJECTIVE

To assess the level of platelet apoptosis markers (phosphatidylserine and calreticulin) under anticoagulation for COVID-19 infection.

MATERIAL AND METHODS

A prospective study included 370 patients. They were divided into 3 groups depending on anticoagulation: group 1 (n=190) — low molecular weight heparin (LMWH); group 2 (n=123) — unfractionated heparin (UFH); group 3 (n=57) — direct oral anticoagulants (DOACs). We assessed clinical and anamnestic data, laboratory parameters, specific markers of apoptosis (phosphatidylserine and calreticulin). To identify cases of VTECs, Doppler ultrasound of lower limb veins was performed.

RESULTS

At the end of anticoagulation, serum calreticulin and phosphatidylserine were higher only in patients taking LMWH (group 1). C-reactive protein decreased in all groups (p=0.135), but serum ferritin and procalcitonin were lower in patients taking LMWH (group 1). The lowest serum fibrinogen was observed in patients taking LMWH. Patients receiving UFH were characterized by higher incidence of isolated pulmonary embolism without deep vein thrombosis (11.4% of cases), DVT and PE with a source in the lower extremities (6.5% and 6.5% of cases, respectively) compared to patients taking LMWH (1.6%, 1.1%, and 0.5% of cases, respectively).

CONCLUSION

Increased apoptosis markers (phosphatidylserine and calreticulin) were found in patients receiving VTEC prophylaxis with low molecular weight heparin. Baseline serum phosphatidylserine >62.75 pg/ml reduces the risk of VTEC by 1.033 times (1.005—1.062, p=0.02). Decrease in pro-inflammatory markers (CRP, ferritin) and coagulation markers (D-dimer and fibrinogen) was more significant in patients receiving LMWH.

Keywords:

phosphatidylserine

calreticulin

apoptosis

venous thromboembolic complications

new coronavirus infection

Authors:

Agapov A.B.

Pavlov Ryazan State Medical University;
Ryazan Regional Clinical Hospital

ORCID: 0000-0003-0178-1649

Kalinin R.E.

Pavlov Ryazan State Medical University

ORCID: 0000-0002-0817-9573

Mzhavanadze N.D.

Pavlov Ryazan State Medical University;
Ryazan City Clinical Emergency Hospital

SPIN RSCI: 7757-8854
Scopus AuthorID: 55440268100
ResearcherID: M-1732-2016
ORCID: 0000-0001-5437-1112

Povarov V.O.

Pavlov Ryazan State Medical University

ORCID: 0000-0001-8810-9518

Nikiforov A.A.

Pavlov Ryazan State Medical University

ORCID: 0000-0002-7364-7687

Suchkov I.A.

Pavlov Ryazan State Medical University

SPIN RSCI: 6473-8662
Scopus AuthorID: 56001271800
ResearcherID: M-1180-2016
ORCID: 0000-0002-1292-5452

Received:

13.09.2023

Accepted:

15.01.2024

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