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Impact of COVID-19 on thrombus composition and response to thrombolysis: Insights from a monocentric cohort population of COVID-19 patients with acute ischemic stroke.
Desilles, Jean-Philippe; Solo Nomenjanahary, Mialitiana; Consoli, Arturo; Ollivier, Véronique; Faille, Dorothée; Bourrienne, Marie-Charlotte; Hamdani, Mylène; Dupont, Sébastien; Di Meglio, Lucas; Escalard, Simon; Maier, Benjamin; Blanc, Raphael; Piotin, Michel; Lapergue, Bertrand; Ajzenberg, Nadine; Vasse, Marc; Mazighi, Mikael; Ho-Tin-Noé, Benoît.
Afiliação
  • Desilles JP; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Solo Nomenjanahary M; Interventional Neuroradiology Department, Biological Resource Center, Rothschild Foundation Hospital, Paris, France.
  • Consoli A; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Ollivier V; Department of Stroke Centre and Diagnostic and Interventional Neuroradiology, University of Versailles and Saint Quentin en Yvelines, Foch Hospital, Suresnes, France.
  • Faille D; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Bourrienne MC; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Hamdani M; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Dupont S; Interventional Neuroradiology Department, Biological Resource Center, Rothschild Foundation Hospital, Paris, France.
  • Di Meglio L; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Escalard S; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Maier B; Interventional Neuroradiology Department, Biological Resource Center, Rothschild Foundation Hospital, Paris, France.
  • Blanc R; Interventional Neuroradiology Department, Biological Resource Center, Rothschild Foundation Hospital, Paris, France.
  • Piotin M; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Lapergue B; Interventional Neuroradiology Department, Biological Resource Center, Rothschild Foundation Hospital, Paris, France.
  • Ajzenberg N; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
  • Vasse M; Interventional Neuroradiology Department, Biological Resource Center, Rothschild Foundation Hospital, Paris, France.
  • Mazighi M; Department of Stroke Centre and Diagnostic and Interventional Neuroradiology, University of Versailles and Saint Quentin en Yvelines, Foch Hospital, Suresnes, France.
  • Ho-Tin-Noé B; Université de Paris and Université Sorbonne Paris Nord, INSERM, LVTS, Paris, France.
J Thromb Haemost ; 20(4): 919-928, 2022 04.
Article em En | MEDLINE | ID: mdl-35032088
BACKGROUND: Resistance to fibrinolysis, levels of procoagulant/antifibrinolytic neutrophil extracellular traps (NETs), and the severity of acute ischemic stroke (AIS) are increased by COVID-19. Whether NETs are components of AIS thrombi from COVID-19 patients and whether COVID-19 impacts the susceptibility of these thrombi to thrombolytic treatments remain unknown, however. OBJECTIVES: We aimed to characterize AIS thrombi from COVID-19 patients by immunohistology and to compare their response to thrombolysis to that of AIS thrombi from non-COVID-19 patients. PATIENTS/METHODS: For this monocentric cohort study, 14 thrombi from COVID-19 AIS patients and 16 thrombi from non-COVID-19 patients, all recovered by endovascular therapy, were analyzed by immunohistology or subjected to ex vivo thrombolysis by tissue-type plasminogen (tPA)/plasminogen. RESULTS: COVID-19 AIS thrombi were rich in neutrophils and contained NETs, but not spike protein. Thrombolysis assays revealed a mean resistance profile to tPA/plasminogen of COVID-19 AIS thrombi similar to that of non-COVID-19 AIS thrombi. The addition of DNase 1 successfully improved thrombolysis by potentiating fibrinolysis irrespective of COVID-19 status. Levels of neutrophil, NETs, and platelet markers in lysis supernatants were comparable between AIS thrombi from non-COVID-19 and COVID-19 patients. CONCLUSIONS: These results show that COVID-19 does not impact NETs content or worsen fibrinolysis resistance of AIS thrombi, a therapeutic hurdle that could be overcome by DNase 1 even in the context of SARS-CoV-2 infection.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Trombose / Isquemia Encefálica / Acidente Vascular Cerebral / AVC Isquêmico / Tratamento Farmacológico da COVID-19 Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Thromb Haemost Assunto da revista: HEMATOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Trombose / Isquemia Encefálica / Acidente Vascular Cerebral / AVC Isquêmico / Tratamento Farmacológico da COVID-19 Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Thromb Haemost Assunto da revista: HEMATOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: França