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Sticky platelet syndrome (SPS) is an inherited thrombophilic condition that causes an abnormal increase in platelet aggregation and favors both arterial and venous thrombotic events1-4. Between January 2020 and August 2023, 11 persons with SPS were diagnosed and treated at the Center for Hematology and Internal Medicine of Puebla (Centro de Hematología y Medicina Interna de Puebla), Mexico. All patients were instructed to take aspirin, 100 mg/day, after the diagnosis of SPS. Five persons were infected with SARS-CoV-2. Two patients had a thrombotic episode in the period of observation; one patient did not have COVID-19 but she developed right iliofemoral thrombophlebitis a year after starting treatment with aspirin (Table 1). We have previously shown that the treatment with aspirin of persons with SPS significantly reduces the rate of re-thrombosis to 4%5. In this group of 11 persons with SPS, we have observed the following: (1) the re-thrombosis rate was very high: 2 out of 11,36%; and (2) in one case, thrombosis was triggered by the SARS-CoV-2 infection in the setting of withdrawal of the antiplatelet treatment.
Table 1. Salient features of the two patients with the sticky platelet syndrome who developed a vaso-occlusive episode
| Characteristics | No SARS-CoV-2 | With SARS-CoV-2 |
|---|---|---|
| Female | 1 | 1 |
| Age | 51 | 37 |
| Treatment start date | May 27, 2020 | January 14, 2022 |
| COVID-19 diagnosis date | NA | July 04, 2023 |
| Thrombotic event date | January 15, 2021 | July 01, 2023 |
| Thrombotic event | Right iliofemoral thrombophlebitis | Ischemic colitis |
| Interruption of treatment | No | Yes |
The rate of thrombosis in patients with COVID-19 is around 13%6. In this small cohort of persons with COVID-19 and SPS (5 patients), the thrombosis rate was 20%, a figure higher than that observed in the general population infected with SARS-CoV-26.
We can assume that the rate of thrombosis in patients with previous prethrombotic states may increase with SARS-CoV-2 infection. More studies are needed to further explore the rate of thrombosis in persons with COVID-19 and SPS.
