Evidence map›Paper›PMID 40123654›Full record

ArticleResearch and practice in thrombosis and haemostasis2025

Relevance of anti-platelet factor 4/heparin antibodies and platelet activation in systemic inflammatory diseases and thrombosis disorders: insight from the COVID-19 pandemic.

Nicolas Gendron, Dominique Helley, Johannes Thaler, Dorothée Faille, Christine Le Beller, Maxime Gruest, Jérôme Hadjadj, Aurélien Philippe, Faris Zeco, Marie Courbebaisse and 19 more

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In one paragraph

Article in Research and practice in thrombosis and haemostasis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Nicolas GendronHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Dominique HelleyHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Johannes ThalerClinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Dorothée FailleParis Cité University, INSERM UMR 1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France, Laboratoire d'Hématologie, AP-HP, Bichat-Claude Bernard Hospital, Paris, France.
Christine Le BellerParis Cité University, INSERM, Paris Cardiovascular Research Centre, Team Endotheliopathy and Hemostasis Disorders, Paris, France.
Maxime GruestHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Jérôme HadjadjSorbonne Université, Service de Médecine interne, Hôpital Saint-Antoine, AP-HP, Imagine Institute, Laboratory for Immunogenetics of Pediatric Autoimmune Diseases, INSERM UMR 1163, Paris, France.
Aurélien PhilippeHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Faris ZecoHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Marie CourbebaisseUniversité Paris Cité, Physiology Department, European Georges-Pompidou Hospital, APHP, INSERM U1151, Paris, France.
Luc DarnigeHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Wafa AmaraHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Leyla CalmetteHematology-Immunology-Transfusion Department, Hôpitaux Universitaires Paris Ile De France Ouest, Université Versailles Saint Quentin, Boulogne, France.
Beatrice ParfaitCentre de Ressources Biologiques de l'Hôpital Cochin, AP-HP.Centre-Université Paris Cité, Paris, France.
Claire AuditeauHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Richard ChocronParis Cité University, INSERM, Paris Cardiovascular Research Centre, F-75015 Paris, France, and Emergency department, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France.
Lina KhiderParis Cité University, INSERM, Paris Cardiovascular Research Centre, Team Endotheliopathy and Hemostasis Disorders, Paris, France.
Laetitia MaugeHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.
Olivier EspitiaNantes Université, CHU Nantes, Department of Internal and Vascular Medicine, l'institut du thorax, INSERM UMR1087/CNRS UMR 6291, Team III Vascular & Pulmonary diseases, Nantes, France.
Gérard FriedlanderFondation Université Paris Cité, Paris, France.
Nadine AjzenbergParis Cité University, INSERM UMR 1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France, Laboratoire d'Hématologie, AP-HP, Bichat-Claude Bernard Hospital, Paris, France.
David LebeauxInstitut Pasteur, Université Paris Cité, CNRS UMR 6047, Genetics of Biofilms Laboratory, Paris, France.
Benjamin PlanquetteF-CRIN INNOVTE, Saint-Étienne, France.
Olivier SanchezF-CRIN INNOVTE, Saint-Étienne, France.
Jean-Luc DiehlParis Cité University, INSERM, Paris Cardiovascular Research Centre, Team Endotheliopathy and Hemostasis Disorders, Paris, France.
COVID-HOP Study Group
Agnès Lillo-Le LouetParis Cité University, INSERM, Paris Cardiovascular Research Centre, Team Endotheliopathy and Hemostasis Disorders, Paris, France.
Benjamin TerrierParis Cité University, INSERM, Paris Cardiovascular Research Centre, F-75015 Paris, France, Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Assistance Publique Hôpitaux de Paris-Centre (APHP-CUP), Paris, France.
David M SmadjaHematology department, Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The increased interest in anti-platelet factor 4 (PF4)-heparin complex (anti-PF4/H) antibodies following the COVID-19 pandemic has established them as crucial players in immunothrombosis. Objectives: We aimed to investigate the involvement of anti-PF4/H antibodies during COVID-19 and after vaccination, particularly in patients with systemic inflammatory disease (SID). Methods: This retrospective study analyzed the presence of anti-PF4/H antibodies and their ability to induce platelet activation in COVID-19 patients with and without suspected heparin-induced thrombocytopenia (HIT), vaccine-induced immune thrombotic thrombocytopenia (VITT) patients, and in controls and SID patients following COVID-19 vaccination. Results: No significant increase in anti-PF4/H antibody levels was observed during COVID-19 regardless of disease severity. Despite a 2-fold increase in HIT suspicion observed during the pandemic, there was no corresponding increase in HIT diagnoses. Additionally, no significant increase in anti-PF4/H levels was noted after vaccination, even in SID patients. None of the positive anti-PF4/H antibodies detected in COVID-19 or vaccination cohorts induced platelet activation, measured by soluble P-selectin levels and flow cytometry-based on platelet microvesicle generation. Finally, in VITT patients, unlike in HIT patients, anti-PF4/H levels were strongly associated with platelet microvesicle assay and moderately with soluble P-selectin levels. Conclusion: Our study found no significant increase in anti-PF4/H antibodies in COVID-19 or after vaccination, including in SID patients. However, in VITT patients, but not in HIT patients, these antibodies were correlated with platelet activation. This finding suggests that anti-PF4/H antibodies play a different role in the pathophysiology of VITT but that their interest is limited outside clear contexts of HIT/VITT suspicion.

Indexed as

antibodiesconnectivite tissue diseaseCOVID-19thrombocytopeniavaccinevasculitis

Identifiers

PMID40123654
PMCPMC11929090

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.