Effects of the circulating environment of COVID-19 on platelet and neutrophil behavior.

Introduction: Thromboinflammatory complications are well described sequalae of Coronavirus Disease 2019 (COVID-19), and there is evidence of both hyperreactive platelet and inflammatory neutrophil biology that contributes to the thromoinflammatory milieu. It has been demonstrated in other thromboinflammatory diseases that the circulating environment may affect cellular behavior, but what role this environment exerts on platelets and neutrophils in COVID-19 remains unknown. We tested the hypotheses that 1) plasma from COVID-19 patients can induce a prothrombotic platelet functional phenotype, and 2) contents released from platelets (platelet releasate) from COVID-19 patients can induce a proinflammatory neutrophil phenotype. Methods: We treated platelets with COVID-19 patient and disease control plasma, and measured their aggregation response to collagen and adhesion in a microfluidic parallel plate flow chamber coated with collagen and thromboplastin. We exposed healthy neutrophils to platelet releasate from COVID-19 patients and disease controls and measured neutrophil extracellular trap formation and performed RNA sequencing. Results: We found that COVID-19 patient plasma promoted auto-aggregation, thereby reducing response to further stimulation ex-vivo. Neither disease condition increased the number of platelets adhered to a collagen and thromboplastin coated parallel plate flow chamber, but both markedly reduced platelet size. COVID-19 patient platelet releasate increased myeloperoxidasedeoxyribonucleic acid complexes and induced changes to neutrophil gene expression. Discussion: Together these results suggest aspects of the soluble environment circulating platelets, and that the contents released from those neutrophil behavior independent of direct cellular contact.

Anxiety, Depression and Influencing Factors of the Elderly Disabled Under the Influence of COVID-19 Outbreak: Evidence from China.

BACKGROUND: The elderly disabled have experienced serious negative emotions during the COVID-19 outbreak. However, the causes of anxiety and depression are not clear. This study aims to explore changes in mental states and influencing factors of the elderly disabled under the influence of the COVID-19 outbreak. SUBJECTS AND METHODS: A total of 253 cases of elderly disabled in Wuhan, China were selected as the research group and observed from April to June 2020. Another 181 cases of elderly disabled in Yichang, China were observed from April to June 2020 and denoted Group A, while 100 cases of elderly disabled in Wuhan were investigated from August to November 2020 and denoted Group B. Another 100 cases of the elderly without disability were chosen as the control group. The Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used. RESULTS: HAMA and HAMD scores of the research group are higher than those of Groups A and B and the control group. HAMA and HAMD scores of Groups A and B are higher than those of the control group (p<0.05). Solitude; pre-existing diseases; no stable and fixed friends; disability level-3 or -4; unmarried, divorced, or widowed; living in Wuhan; COVID-19 are risk factors for developing anxiety and depression in the elderly disabled after multivariate logistics regression (p<0.05). CONCLUSIONS: The incidence rate of anxiety and depression is very high in the elderly disabled under the influence of the COVID-19 outbreak in Wuhan, China.