• Platelets · Nov 2020

    Case Reports

    A proof of evidence supporting abnormal immunothrombosis in severe COVID-19: naked megakaryocyte nuclei increase in the bone marrow and lungs of critically ill patients.

    • Luca Roncati, Giulia Ligabue, Vincenzo Nasillo, Beatrice Lusenti, William Gennari, Luca Fabbiani, Claudia Malagoli, Graziana Gallo, Silvia Giovanella, Massimo Lupi, Tiziana Salviato, Ambra Paolini, Matteo Costantini, Tommaso Trenti, and Antonio Maiorana.
    • Institute of Pathology, University of Modena and Reggio Emilia , Modena, Italy.
    • Platelets. 2020 Nov 16; 31 (8): 1085-1089.

    AbstractCoronavirus disease 2019 (COVID-19) is a global public health emergency with many clinical facets, and new knowledge about its pathogenetic mechanisms is deemed necessary; among these, there are certainly coagulation disorders. In the history of medicine, autopsies and tissue sampling have played a fundamental role in order to understand the pathogenesis of emerging diseases, including infectious ones; compared to the past, histopathology can be now expanded by innovative techniques and modern technologies. For the first time in worldwide literature, we provide a detailed postmortem and biopsy report on the marked increase, up to 1 order of magnitude, of naked megakaryocyte nuclei in the bone marrow and lungs from serious COVID-19 patients. Most likely related to high interleukin-6 serum levels stimulating megakaryocytopoiesis, this phenomenon concurs to explain well the pulmonary abnormal immunothrombosis in these critically ill patients, all without molecular or electron microscopy signs of megakaryocyte infection.

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