Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children49710.24287/1726-1708-2021-20-1-184-191LITERATURE REVIEWОБЗОР ЛИТЕРАТУРЫPlatelets in COVID-19: “innocent by-standers” or active participants?Тромбоциты при COVID-19: «случайные прохожие» или соучастники?https://orcid.org/0000-0002-9023-901XAnO. I.АнО. И.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0003-0211-6325MartyanovA. A.МартьяновА. А.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0001-7509-6316StepanyanM. G.СтепанянМ. Г.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0003-4252-5588BoldovaA. E.БолдоваА. Е.
Russian Federation

Moscow

Москва

RumyantsevS. A.РумянцевС. А.
Russian Federation

Moscow, Troitsk

Москва, Троицк

https://orcid.org/0000-0002-8128-7757PanteleevM. A.ПантелеевМ. А.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-6668-0948AtaullakhanovF. I.АтауллахановФ. И.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-1643-5960RumyantsevA. G.РумянцевА. Г.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0003-4720-7319SveshnikovaA. N.СвешниковаА. Н.
Russian Federation

head of the Intracellular signalling and systems biology laboratory, Center for Theoretical Problems of Physicochemical Pharmacology, RAS;30 Srednyaya Kalitnikovskaya st., 109029 Moscow

заведующая лабораторией внутриклеточной сигнализации и системной биологии ФГБУН «Центртеоретических проблем физикохимической фармакологии» РАН,

109029, Москва, ул. Средняя Калитниковская, 30

a.sveshnikova@physics.msu.ruI.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)ФГБУН «Центр теоретических проблем физико-химической фармакологии» РАНCenter for Theoretical Problems of Physicochemical Pharmacology, RASDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Healthcare of the Russian FederationФГБУН «Центр теоретических проблем физико-химической фармакологии» РАНLomonosov Moscow State UniversityФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава РоссииN.M. Emanuel Institute of Biochemical Physics, RASФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»ФГБУН «Институт биохимической физики им. Н.М. Эмануэля» РАНCenter for Theoretical Problems of Physicochemical Pharmacology, RASLomonosov Moscow State UniversityФГБУН «Центр теоретических проблем физико-химической фармакологии» РАНФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»Center for Theoretical Problems of Physicochemical Pharmacology, RASФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»Hospital of the Russian Academy of Sciences (Troitsk)ФГБУЗ Больница Российской академии наукCenter for Theoretical Problems of Physicochemical Pharmacology, RASDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Healthcare of the Russian FederationФГБУН «Центр теоретических проблем физико-химической фармакологии» РАНФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Healthcare of the Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава РоссииI.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian FederationCenter for Theoretical Problems of Physicochemical Pharmacology, RASФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Healthcare of the Russian FederationФГБУН «Центр теоретических проблем физико-химической фармакологии» РАНФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»210420212011841912104202121042021Copyright ©; 2021, «D. Rogachev NMRCPHOI»Copyright ©; 2021, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2021«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/497

One of the most dangerous features of the new coronavirus infection caused by the SARS-CoV-2 virus is the tendency of the hemostasis system of patients to excessive thrombus formation. Among the possible causes of this pathology, both the activation of vascular endothelial cells, leading to the exposure of tissue factor by these cells, and direct activation of the plasma hemostasis were named. Besides, there is a significant change in platelet responses to activation, which is not accompanied by significant thrombocytopenia. The mechanism of platelet dysfunction is rather controversial. On the one hand, there are suggestions that platelets can act as a direct “container” for the virus, thus spreading it throughout the body. On the other hand, the presence of viral RNA in platelets has been demonstrated in only one study, while other authors have obtained the opposite result. Another mechanism of the virus's direct effect on platelets is the penetration of the virus into megakaryocytes and the subsequent violation of thrombocytopoiesis. However, three of the four published works show that platelets from patients with SARS-CoV-2 are in an activated state (the so-called platelet pre-activation). This phenomenon can be caused by the direct influence of the virus and the effect of thromboinflammation in the lungs on platelet functions. Here we review the known data and possible causes of the platelet functionality changes observed in patients with SARS-CoV-2. 

Одной из наиболее опасных особенностей новой коронавирусной инфекции, вызванной вирусом SARS-CoV-2, является склонность системы гемостаза больных к избыточному тромбообразованию. Среди возможных причин данной патологии выделяют как активацию эндотелиоцитов сосудов, приводящую к выставлению тканевого фактора этими клетками, так и активацию плазменного звена гемостаза. Кроме того, показано, что при SARS-CoV-2 наблюдается значительное изменение функциональных ответов тромбоцитов на активацию, которое, однако, не сопровождается значительной тромбоцитопенией. Механизм влияния на функциональность и количество тромбоцитов представляется достаточно противоречивым. С одной стороны, существуют предположения, что тромбоциты могут выступать непосредственным «контейнером» для вируса, распространяя по организму. С другой стороны, наличие вирусной РНК в тромбоцитах было продемонстрировано только в одном исследовании, тогда как другие авторы получили обратный результат. Еще одним механизмом непосредственного воздействия вируса на тромбоциты является его проникновение в мегакариоциты и последующее нарушение тромбоцитопоэза. Тем не менее в 3 из 4 опубликованных на настоящий момент работ показано, что тромбоциты пациентов с SARS-CoV-2 находятся в активированном состоянии (так называемая подактивация тромбоцитов). Это явление может быть вызвано как прямым влиянием вируса, так и влиянием на функции тромбоцитов идущего в легких процесса. В настоящем обзоре мы рассматриваем существующие данные и возможные причины изменения функциональности тромбоцитов, наблюдаемого у пациентов с SARS-CoV-2. 

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