Increased platelet-neutrophil aggregate ratio after severe acute respiratory syndrome coronavirus 2 vaccination and severe infection.

Publication date: Jul 17, 2025

ObjectivesPlatelet-neutrophil aggregates (PNA) bridge inflammatory processes with the hemostatic system. The goal of this study was the comparative evaluation of PNAs in healthy individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), septic patients, coronavirus disease 2019 (COVID-19) patients, and a pre-pandemic control group from 2019. MethodsThis observational study involved prospective blood sample collection from vaccinated individuals at separate times after immunization with Pfizer-BioNTech mRNA vaccine, together with the retrospective analysis of laboratory data from COVID-19, sepsis, and control subjects. PNA ratios and anti-S-protein antibody levels were also measured. ResultsFollowing primary SARS-CoV-2 vaccination, PNA levels increased significantly, showing a gradual decline over six months while remaining elevated. Booster vaccinations did not elevate PNA levels. In COVID-19 patients PNA ratios were the highest, while in the patients with sepsis remained comparable to those of the control group. A moderate correlation was found between PNA and anti-S-protein levels after primary immunization (rho = 0. 31, p = 0. 0071), but no correlation was observed post-booster. Strong associations between PNA and platelet counts occurred in COVID-19 and sepsis groups, while leukocyte and neutrophil counts showed no significant correlations with PNA. ConclusionsThe results of this study may support the possibility of using PNA ratio assessment for the evaluation of the immune response.

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Concepts Keywords
Biontech Adult
Coronavirus Aged
Healthy Antibodies, Viral
Vaccinated Antibodies, Viral
Blood Platelets
BNT162 Vaccine
BNT162 Vaccine
coronavirus disease 2019
COVID-19
COVID-19 Vaccines
COVID-19 Vaccines
Female
Humans
Male
Middle Aged
Neutrophils
neutrophils
Pfizer-BioNTech mRNA vaccine
Platelet–neutrophil aggregates
platelets
Prospective Studies
Retrospective Studies
SARS-CoV-2
Sepsis
Vaccination

Semantics

Type Source Name
disease MESH infection
disease MESH coronavirus disease 2019
disease IDO blood
disease MESH sepsis
disease IDO immune response
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
drug DRUGBANK Esomeprazole
pathway REACTOME Hemostasis
disease MESH thrombosis
disease MESH inflammation
pathway REACTOME Release
pathway KEGG Platelet activation
drug DRUGBANK Thrombin
drug DRUGBANK L-Leucine
pathway REACTOME Antimicrobial peptides
drug DRUGBANK Fibrinogen Human
pathway KEGG Neutrophil extracellular trap formation
disease IDO pathogen
disease MESH complications
disease MESH thromboinflammation
disease MESH death
disease IDO process
disease IDO protein
disease IDO country
disease MESH anemia
disease MESH chronic diseases
drug DRUGBANK Edetic Acid
disease IDO reagent
disease IDO assay
disease MESH viral infections
disease MESH leukocytopenia
disease MESH thrombocytopenia
disease MESH deep venous thrombosis
disease MESH tumor
disease MESH metastasis
drug DRUGBANK (S)-Des-Me-Ampa
pathway REACTOME Signal Transduction
disease MESH infectious diseases
disease MESH pneumonia
drug DRUGBANK Caplacizumab
pathway REACTOME Immune System
disease MESH hypercoagulability
disease MESH lung injury
drug DRUGBANK Elm

Original Article

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