Abstract. Essential thrombocythemia (ET) is a very rare disorder with 1- /100,000 population in the world. The incidence of this abnormality is still obscure in Indonesia. We report a case of ET, women of age 74 years old that came to Sanjiwani Hospital with gum bleeding. This case is confirmed based on WHO criteria of ET which are the increasing of thrombocyte of a number of increase >450 /µL3, proliferation of megakaryocyte cell on bone marrow biopsy, also not meeting any other WHO criteria for also not meeting any other WHO criteria for BCR-ABL1+CML, Polycythemia Vera, Chronic Myeloid Leukemia, Myelodysplastic Syndrome, or other myeloid neoplasm diseases. Management of this case is based on risk adapted treatment algorithm considering three major risk factors for thrombosis (history of thrombosis, JAK2/MPL mutations, and advanced age). This case is categorized as high risk patient for thrombosis, so that treated with antiplatelet aggregation (aspilets) and anagrelide after hydroxyurea clinically unresponsive.

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Experts have speculated the potential of heparin administration as COVID-19 treatment modality, although scientific research regarding its effectivity, recommended dosage, and period are still minimal. This study aims to explore the capacity of LMWH as a medicament for COVID-19, in effort to provide scientific reference for further development of COVID-19 possible choice of treatment or medicament. A retrospective study was conducted in Udayana University Hospital, Bali, Indonesia. Data were sourced from laboratory-confirmed COVID-19 patients medical records during March 25 to July 31, 2020. Clinical, laboratory, treatment and use of LMWH data were reviewed and statistically processed.  42 patients we found Use of LMWH. The patient categorizes from moderate to severe COVID-19. 31 patients use of LMWH for prophylaxis and 11 patients use of LMWH for treatment. 7 patients were death in the hospital, and the other was survived. LMWH elevates coagulation dysfunction in COVID-19 patients. We believe that beneficial effects of LMWH as prophylaxis or treatment in COVID-19 patients.

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