Dynamic Characteristics of Blood Platelet Count in COVID-19 Patients

Background and purpose: Coronavirus disease 2019 (COVID-19) was spreading all over the world. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) primarily invades and infects the lungs of humans leading to COVID-19. Mild to severe clinical symptoms such as fever, cough, and shortness of breath were existed in those patients. One of the most common changes in these patients was abnormal blood routine. However, uncertainty remains regarding the dynamic characteristics of platelet in COVID-19 patients due to limited data. Therefore, we aimed to analyze the association between dynamic characteristics of blood platelet and disease severity, and to identify new monitoring indicators to treat the COVID-19 patients. Methods: In this cohort study, 398 COVID-19 patients treated in the Shenzhen Third People’s hospital from December 16, 2019 to March 26, 2020 were collected and participated. All data of participants including the clinical characteristics, imaging and laboratory information were collected. All patients included in our study were classified as four groups (mild, common, severe, and critical types) regarding clinical symptoms and relevant severe failures based on the Diagnosis Criteria. Platelet count was examined at the baseline and every 3–5 days during hospitalization. Results: The platelet count varied with clinical classifications. The platelet count in mild type was normal without significant fluctuation. While the blood platelet count of most common and severe patients had obvious fluctuations, showing as a dynamic change that first rose and then fell to the level at admission, which was consistent with the trend of lung inflammation. Bone marrow smears further showed that bone marrow hyperplasia was normal in mild, common and severe type patients, and megakaryocytes and their platelet-producing functions were not abnormal. Conclusions: Our results suggested that the dynamic changes of platelet count might be a predictor of lung inflammation alteration for COVID-19 patients. The changes in platelet count might be a responsive pattern secondary to lung inflammation. The function of bone marrow may be slightly affected by SARS-CoV-2 infection.

The Changes of Blood Platelet Reactivity in the Presence of Crude Extracts Isolated from Leaves and Twigs of Elaeagnus Rhamnoides (L.) A. Nelson Measuring in Whole Blood

Uncontrolled blood platelet activation is an important risk factor of cardiovascular disease (CVDs). Various studies on phenolic compounds indicate that they have a protective effect on the cardiovascular system through different mechanisms, including the reduction of blood platelet activation. One of the plants that is particularly rich in phenolic compounds is sea buckthorn (Elaeagnus rhamnoides (L.) A. Nelson). The aim of the present study in vitro was to determine the anti-platelet properties of crude extracts isolated from leaves and twigs of E. rhamnoides (L.) A. Nelson in whole blood using flow cytometric and total thrombus-formation analysis system (T-TAS). The aim of our study was also analyze of blood platelet proteoms in the presence of different sea buckthorn extracts. A significant new finding is a decrease surface expression of P-selectin on blood platelets stimulated by 10 µM ADP and 10 µg/mL collagen, and a decrease surface expression of GPIIb/IIIa active complex on non-activated platelets and platelets stimulated by 10 µM ADP and 10 µg/mL collagen in the presence of sea buckthorn leaf extract (especially at the concentration 50 µg/mL). The twig extract also displayed antiplatelet potential. However, this activity was higher in the leaf extract than in the twig extract in whole blood. In addition, our present findings clearly demonstrate that investigated plant extracts have anticoagulant properties (measured by T-TAS). Therefore, the two tested extracts may be promising candidates for the natural anti-platelet and anticoagulant supplements.

Statistical characteristics of the components of coagulation hemostasis and the degree of oxygenation of rat blood in the normal and at different times of the experimental opioid effect

Background. The problem of non-drug use of opioid drugs occupies a significant place among the current problems of world medicine. Objective. Тo study the hematological parameters of coagulation hemostasis in the norm and the dynamics of their changes at different times of opioid exposure. Methods. The experimental study was performed on sexually mature, outbred male rats in the number of 80 animals, weighing 160-270 g, aged 4.5-7.5 months. Animals were injected intramuscularly with “Nalbuphine” once daily for one day (10-11 hours in the morning) for 98 days. The initial dose of nalbuphine during the first 2 weeks was 0.212 mg / kg, the next 2 (II - IV weeks) - 0.225 mg / kg, the next (IV - VI weeks) - 0.252 mg / kg, the next (VI - VIII weeks) ) - 0.260 mg / kg, the next (VIII - X weeks) - 0.283 mg / kg, the next (X - XII weeks) - 0.3 mg / kg, and during (XII - XIV weeks) - 0.454 mg / kg. Thus, the conditions for chronic opioid exposure were created. Animals are divided into 3 groups. The 1-st group of animals received Nalbuphine for 98 days, with subsequent collection of material (end of 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks and 14 weeks of experimental opioid exposure); The 2-d was the control group, which for 98 days received injections of saline intramuscularly in one period of time (10 - 11 o'clock in the morning). Blood sampling and study of hematological parameters of blood (platelet count, prothrombin time, prothrombin index, time of recalcification of stabilized blood, total fibrinogen, determination of hemoglobin, hematocrit) were performed according to conventional methods. Software R v 4.0.3 and RStudio v 1.2.5042 were used for statistical calculations and graphing. MSOffice Excel 2010 spreadsheets were used to generate the final tables and store the data. Results. The key to the dynamics of changes in the blood parameters of experimental animals was week 6 of the experiment, as most indicators had the highest dynamics up to 6 weeks including further indicators of stability, which was higher (fibrinogen and prothrombin index) or less (prothrombin time, recalcification time and hemoglobin) indicators of the control group. The blood hematocrit of the experimental animals decreased evenly at all study terms to a minimum value at 14 week, and the number of platelets evenly all times increased to a maximum value at the last term of the experiment. This trend in all indicators was confirmed statistically. Conclusion. Our research has made it possible to study first and then observe the dynamics of changes in coagulation hemostasis and the degree of oxygenation of blood in acute, subchronic and chronic periods of experimental opioid exposure with subsequent statistical comparison.

Diagnostic value of platelet parameters and megakaryocyte formula of bone marrow in idiopathic thrombocytopenic purpura

The parameters of the megakaryocyte formula and peripheral blood platelet indices were studied in 237 people with diagnoses of idiopathic thrombocytopenic purpura (ITP) and myelodysplastic syndrome (MDS). A correlation analysis was performed between megakaryocyte subpopulations and platelet counts. The threshold values for MPV, PCT and PDW were determined by ROC analysis with the construction of the ROC curve, the calculation of the area under the curve (AUC) and the cutoff threshold. The obtained values make it possible to make a differential diagnosis between ITP and MDS by platelet parameters of peripheral blood without examining the bone marrow.

Cord Blood Platelet Gel as a Treatment of Occipital Pressure Injuries in Newborns: Report of Two Cases

Background: A Pressure Ulcer (PU) is a severe event and could create discomfort to newborns. In newborns, one of mostly stricken location by PU is occipital area. Recent studies have highlighted that Cord Blood Platelet Gel (CBPG) might be a better alternative compared to traditional treatment. We report two cases of occipital PU treated with CBPG. Case report: Two male infants showing occipital PU were treated with standard local treatment, but no improvement was observed. After parental informed consent was obtained, CBPG application on PU was performed every 48 h. In these two cases of PU, a fast improvement in healing was observed since the first application of CBPG. The PU healed resulted in a scar after 53 and 50 days (Case 1 and Case 2, respectively) from development. No complications or infections were reported. Conclusions: CBPG contains many angiogenetic and growth factors, these characteristics make it indicated in treating soft tissue injuries. It would seem to be safe and an effective treatment of neonatal PUs reducing the time of the healing and the hospitalization and the infectious risks. Further studies are needed to evaluate long term aesthetic and functional results of PU treated with CBPG.

Preparations from selected cucurbit vegetables as antiplatelet agents

Increased blood platelet activation plays an important role in cardiovascular diseases (CVDs). Recent experiments indicate that certain fruits and vegetables, including onion, garlic, and beetroot, have anti-platelet potential and therefore may reduce the likelihood of CVDs. While vegetables from the Cucuritaceae family are known to exerting beneficial antioxidant and anti-inflammatory effects, their effects on blood platelet activation are poorly understood. Therefore, the aim of the present study was to determine the effect on platelet adhesion of preparations from selected cucurbits: pumpkin (Cucurbita pepo; fruit without seeds), zucchini (Cucurbita pepo convar. giromontina; fruit with seeds), cucumber (Cucumis sativus; fruit with seeds), white pattypan squash (Cucurbita pepo var. patisoniana; fruit without seeds) and yellow pattypan squash (Cucurbita pepo var. patisoniana, fruit without seeds). It also evaluates the activity of these preparations on enzymatic lipid peroxidation in thrombin-activated washed blood platelets by TBARS assay. The study also determines the anti-platelet properties of these five cucurbit preparations in whole blood by flow cytometry and with the total thrombus-formation analysis system (T-TAS) and evaluates the cytotoxicity of the tested preparations against platelets based on LDH activity. The results indicate that the yellow Cucurbita pepo var. patisoniana preparation demonstrated stronger anti-platelet properties than the other tested preparations, reducing the adhesion of thrombin-activated platelets to collagen/fibrinogen, and inhibiting arachidonic acid metabolism and GPIIb/IIIa expression on 10 µM ADP-activated platelets. None of the preparations was found to cause platelet lysis. Our findings provide new information on the anti-platelet activity of the tested cucurbit preparations and their potential for treating CVDs associated with platelet hyperactivity.

A Suspected Case of Idiopathic Thrombocytopenic Purpura - A Case Report

Objectives: This study demonstrated the positive effect of herbal medication on a suspected idiopathic thrombocytopenic purpura (ITP) patient-a 57-year-old male with suspected ITP and a decreased platelet count.Methods: The patient was treated with an herbal medicine named Nokyongdaebo-tang, and its effect was measured with periodic platelet blood tests.Results: Before taking the herbal medicine, the patient’s blood platelet count was 98 K/μl, but following treatment, the blood platelet count increased to 201 K/μl and maintained a continuously elevated level.Conclusion: The results indicated that herbal medication may improve the blood platelet count of suspected ITP patients.

Ergothioneine supplementation in people with metabolic syndrome (ErgMS): protocol for a randomised, double-blind, placebo-controlled pilot study

Background Ergothioneine is a naturally occurring metabolite of histidine found in many foods and in high amounts in mushrooms. In vivo, ergothioneine acts as an antioxidant and is widely distributed in most mammalian tissues. While ergothioneine is sold as a dietary supplement for its antioxidant and anti-inflammatory properties, to date there are no published intervention trials examining its health benefits in humans. The aim of this work was to develop a study protocol for a pilot interventional trial that will establish the primary and secondary outcomes, and the power required, for a definitive randomised controlled trial to test the hypothesis that ergothioneine supplementation is beneficial for people with metabolic syndrome. Methods We have designed the ErgMS study as a single-centre, randomised, double-blind, placebo-controlled, 3-arm parallel, pilot intervention trial, which aims to supplement participants with either placebo, 5 or 30 mg/day ergothioneine for 12 weeks. Measurements of metabolic syndrome risk factors, serum markers of oxidative stress (lipid peroxidation), inflammation, blood platelet function and liver function will take place at baseline, and after 6 weeks and 12 weeks of supplementation. In addition, we will examine if there are any changes in the serum metabolome in response to ergothioneine supplementation. Linear regression and two-way ANOVA will be utilised to analyse the association between ergothioneine and measured variables. Discussion The ErgMS study will be the first study to address the question does ergothioneine supplementation have health benefits for people with metabolic syndrome. Study results will provide preliminary data as to which dose may improve inflammatory markers in adults with metabolic syndrome and will inform dose and primary outcome selection for a definitive randomised controlled trial. Trial registration ISRCTN, ISRCTN25890011 Registered February 10th, 2021