The Role of Zinc and Copper in Platelet Activation and Pathophysiological Thrombus Formation in Patients with Pulmonary Embolism in the Course of SARS-CoV-2 Infection

Simple Summary Recent studies associated COVID-19 with coagulation dysfunction and increased risk of thromboembolism. Consequently, pulmonary embolism (PE) development and higher odds of mortality were observed in this group of patients. CRP levels, which are considered a sensitive marker of systemic inflammation, were linked to the higher rates of PE and immunologic processes associated with atherosclerosis development and thrombus formation. Several microelements, including zinc and copper, were shown to present anti-inflammatory and anti-oxidative characteristics. Due to these properties, and they're in-fluence on platelets activation and thrombus formation, zinc and copper should be evaluated as a potential therapeutic option during COVID-19. To date, many studies have proved that COVID-19 increases the incidence of thrombus formation and coagulopathies but the exact mechanism behind such a disease outcome is not well known. In this review we collect the information and discuss the pathophysiology of thrombus formation in patients with pulmonary embolism in the course of COVID-19 disease and the role of zinc and copper in the process. Supplementation of zinc and copper may be beneficial for COVID-19 patients due to its anti-inflammatory and anti-oxidative properties. On the other hand, excess of those microelements in the organism may be harmful, that is why marking the level of those micronutrients should be done at first. We also propose further investigation of diagnostic and therapeutic options of zinc and copper in course of COVID-19 thrombus formation to their potential in patient care, with particular emphasis on the dosage and the duration of their misbalance.