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Viral Infection and Platelets’ Disorders

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A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 1419

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Special Issue Editors

Dr. Pierpaolo Di Micco

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Guest Editor

UOC Medicina, Fatebenefratelli Hospital of Naples, 80131 Naples, Italy
Interests: internal medicine; management of internal medicine; thrombotic disease
Special Issues, Collections and Topics in MDPI journals

Dr. Alessandro Perrella

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Guest Editor

Emerging Infectious Disease at High Countagiousness, AORN Ospedali dei Colli—P.O. D.Cotugno, 80131 Naples, Italy
Interests: infectious disease; transplants; immunology; AI; healthcare management; antimicrobial stewardship
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Dr. Giuseppe Camporese

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Department of Internal Medicine, General Medicine Unit, Thrombotic and Haemorrhagic Disorders Unit, University Hospital of Padua, Padua, Italy
Interests: vascular medicine; cardiology; coagulation and thrombotic disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Platelet abnormalities have often been reported during any type of infection, and viral infections seem to be more frequently associated with thrombocytopenias. Yet, because platelet abnormalities may be due to viral infections and different pathophysiological mechanisms but can also be associated with underlying diseases or to the use of some drug, they have not been consistently studied, in particular, regarding their prognosis. Frequently, in fact, viral-induced thrombocytopenias show a clinical paradox and are associated with thrombotic manifestations such as thrombotic microangiopathies or disseminated intravascular coagulation, while drug induced thrombocytopenias are more frequently associated with bleeding.

On the other hand, viral infections may be associated with thrombocytosis with or without an underling predisposition to essential thrombocytemia.

For this reason, this Special Issue is directed to scholars involved in the clinical management of viral infection and their complications associated with platelets’ abnormalities as well as to all physicians that are devoted to the management of thrombotic/hemorragic complications associated with platelets’ abnormalities.

Dr. Pierpaolo Di Micco
Dr. Alessandro Perrella
Dr. Giuseppe Camporese
Guest Editors

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Keywords

viral infections
thrombosis
thrombotic microangiopathies
disseminated intravascular coagulation
low molecular weight heparin
bleedings
acute infections

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Published Papers (1 paper)

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Review

11 pages, 965 KB

Open AccessReview

The Platelet–Virus Axis in Human Disease

by Carmine Siniscalchi, Manuela Basaglia, Egidio Imbalzano and Pierpaolo Di Micco

Viruses 2026, 18(2), 183; https://doi.org/10.3390/v18020183 - 29 Jan 2026

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Abstract

Platelets have traditionally been viewed as passive cellular elements involved in hemostasis and vascular integrity. However, growing evidence over the last decade has radically changed this paradigm, revealing platelets as dynamic immune and inflammatory effectors that actively participate in host–pathogen interactions. In viral infections, platelets are not merely innocent bystanders but represent key players in a bidirectional and tightly regulated platelet–virus axis that influences viral dissemination, immune activation, endothelial dysfunction, and the development of thrombotic and hemorrhagic complications. Several clinically relevant viruses, including SARS-CoV-2, influenza virus, HIV, dengue virus, and viral hemorrhagic fever-associated pathogens, have been shown to directly or indirectly interact with platelets through surface receptors, immune complexes, and inflammatory mediators, leading to platelet activation, phenotypic reprogramming, and accelerated clearance. These processes contribute to the paradoxical coexistence of thrombocytopenia and hypercoagulability that characterizes many severe viral diseases. Moreover, platelets can act as immune sentinels by sensing viral components, releasing cytokines and chemokines, forming platelet–leukocyte aggregates, and modulating both innate and adaptive immune responses, thereby shaping the clinical course of infection. In this review, we synthesize current evidence on the molecular and cellular mechanisms governing virus–platelet interactions, with particular emphasis on their role in immune-thrombosis, endothelial injury, and organ dysfunction. We further discuss the clinical implications of platelet dysregulation in viral infections, including its potential value as a biomarker of disease severity and as a therapeutic target. Understanding the platelet–virus axis provides a unifying framework to explain the thrombo-inflammatory phenotype of viral diseases and may open new avenues for risk stratification and targeted interventions in affected patients. Full article

(This article belongs to the Special Issue Viral Infection and Platelets’ Disorders)

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