SARS-CoV-2 binds platelet ACE2 to enhance thrombosis in COVID-19

An increased mean platelet volume (MPV) and platelet hyperactivity that correlated with the decrease in overall platelet count were observed in COVID-19 patients. Platelets express ACE2 and TMPRSS2, indicating the possibility of platelets to directly associate with SARS-CoV-2 virions. The viral particle and spike protein enhance thrombosis formation in mice transduced with human ACE2 transgenic platelets. Binding of SARS-CoV-2 particle or spike protein directly stimulates platelets to release of coagulation factors.