A case of newly diagnosed immune thrombocytopenia in the COVID-19 era

Clerici, Bianca; Birocchi, Simone; Bertinato, Elena; Benedetto, Clara Di; Caberlon, Sabrina; Cattaneo, Marco; Podda, Gian Marco

doi:10.1007/s11739-020-02553-3

Cited by 4 publications

(7 citation statements)

References 19 publications

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“…This study included a total of 7 case reports, two of them were reported from the United States [ 17 , 18 ], one from Canada [ 19 ], one from Italy [ 20 ], one from Turkey [ 21 ], and one from Greece [ 22 ]. The lowest platelet count ranged from 1 × 10 9 /L in Clerici et al [ 20 ] to 23 × 10 9 /L in Lévesque et al [ 19 ]. These characteristics are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“… ITP manifested late after the COVID-related classic clinical symptoms started, was not accompanied by any cutaneous manifestations of ITP, and had no severe hemorrhages. Canada 23 × 10 9 /L 178 × 10 9 /L Recovery Bennett et al, 2020 [ 17 ] Case report 73 Female Fever, shortness of breath, and diarrhea Hypertension and hyperlipidemia COVID-19 infection caused by ITP USA 8 K/μL 146 K/μL Recovery Clerici et al, 2020 [ 20 ] Case report 64 Male Unexplained fever following contact with a known SARS-CoV-2-positive subject, atraumatic epistaxis, and appearance of mucocutaneous petechiae Diabetes mellitus and arterial hypertension COVID-19 infection and persistent ITP Italy 1 × 10 9 /L 118 × 10 9 /L Recovery Martincic et al, 2020 [ 23 ] Case report 48 Male Dyspnea, cough, fever with the highest temperature of 38.5°C, headache, and muscle ache T2DM, obesity, and obstructive sleep apnea COVID-19 associated with ITP and supported by an isolated thrombocytopenia Slovenia 4,000/mm 3 9,000/mm 3 Recovery Hindilerden et al, 2020 [ 21 ] Case report 86 Male A 1-week history of excessive bruising, fatigue, fever, and dry cough Hypertension and T2DM ITP associated with COVID-19 at first presentation, along with purpuric...…”

Section: Resultsmentioning

confidence: 99%

“…Clerici et al reported a 64-year-old male patient presenting with unexplained fever following contact with a known SARS-CoV-2 positive subject, and traumatic epistaxis and mucocutaneous petechiae were reported. The patient recovered after being diagnosed with COVID-19 infection and ITP [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most patients who received platelet transfusion alone did not improve. Two patients received romiplostim in combination with IVIG and showed complete response [ 19 , 20 ]. Methylprednisolone only [ 25 ], or in combination with IVIG [ 19 , 26 , 27 ], Romiplostim [ 20 ], and eltrombopag [ 27 ] lead to complete response.…”

Section: Clinical Characteristics Of the Included Studiesmentioning

confidence: 99%

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COVID-19 associated with immune thrombocytopenia: a systematic review and meta-analysis

Alharbi

2022

Expert Review of Hematology

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Background Immune thrombocytopenia, also known as immune thrombocytopenic purpura (ITP), has emerged as a significant COVID-19-associated complication. This study analyzes the published literature of case reports and case series regarding COVID-19 infection associated with ITP. Methodology In this systematic review and meta-analysis, a systematic search was conducted through PubMed, Web of Science, and Medline through Clarivate and EBSCO to include the eligible studies. The authors utilized Review Manager 5.4 to conduct quantitative data synthesis for the condition of interest analysis. Results A total of 13 eligible case reports and case series with 42 patients were included in this study; 54.8% of them were male. The pooled mean age of all participants was (59.5 ± 19) years with a median age of 63 years. The estimated mean time from diagnosis with COVID-19 to ITP development was 18.1 ± 21 days and the mean time to recovery from ITP was 5.8 ± 4.8 days. The pooled random effect of mean platelet count in the included six studies was 14.52, CI [8.79, 20.25]. Conclusion Our analysis shows that ITP secondary to COVID-19 infection is slightly more prevalent among males (54.8%). Elderly patients were more vulnerable to the disease. Most cases developed ITP within 2–3 weeks after COVID-19 infection and recovered in less than one week from ITP.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Clinical Characteristics Of the Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

COVID-19 associated with immune thrombocytopenia: a systematic review and meta-analysis

Alharbi

2022

Expert Review of Hematology

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“…After the search, 32 articles with a total of 56 cases were selected. 1–32 Our own patient was also included in the final analysis, so 57 cases were analyzed.…”

Section: Methodsmentioning

confidence: 99%

Immune thrombocytopenia and COVID-19: Case report and review of literature

Alonso-Beato

Morales‐Ortega

Fernández

et al. 2021

Lupus

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Immune thrombocytopenia, also known as immune thrombocytopenic purpura (ITP), has been reported as an important complication related to COVID-19. We present a 49-year-old male patient with systemic lupus erythematosus with lupus nephritis, antiphospholipid syndrome and history of ITP who developed an ITP flare in the context of COVID-19. He had no bleeding manifestations and had a good response to prednisone treatment. We review the characteristics of the cases reported to date in the literature, with an analysis of 57 patients. Mean age was 56 years (±19.6 SD), and 50.9% were male. This was the first episode of ITP in most of the patients (86.05%), with SARS-CoV-2 acting as the initial trigger. We found that ITP flares may appear in both mild and severe COVID-19 cases. They also appeared at any time during the course of the disease, 48.2% of patients developed it during hospitalization, while it was diagnosed at admission in the rest of the cases. Platelet counts were significantly lower than other ITP series, with a median nadir platelet count of 8 × 109/L (IQR 2–17.75 × 109/L). These patients show a higher bleeding rate (61.4%) compared with other ITP series. They also show a better response to treatment, with good response to the first line therapies in 76.9% of them. The most common first-line treatment was intravenous immunoglobulin (IVIG), used alone or combined with corticosteroids in 40.4% and 32.7% of cases respectively, while 25% of patients received only corticosteroids. Our review suggests that COVID-19-related ITP can be seen even in previously healthy patients. Clinicians must be aware that ITP may appear both in mild and severe COVID-19, at any time during its course. Given that this kind of ITP seems to be associated with a higher bleeding risk, its diagnosis in a clinical scenario such as COVID-19, where anticoagulant therapy is frequently used, may be critical. Treatment with IVIG and/or corticoids is often effective.

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SARS-CoV-2 infection-induced immune thrombocytopenia: a systematic review of current reports

Ono,

Kitagawa

2024

Ann Hematol

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A case of newly diagnosed immune thrombocytopenia in the COVID-19 era

Cited by 4 publications

References 19 publications

COVID-19 associated with immune thrombocytopenia: a systematic review and meta-analysis

COVID-19 associated with immune thrombocytopenia: a systematic review and meta-analysis

Immune thrombocytopenia and COVID-19: Case report and review of literature

SARS-CoV-2 infection-induced immune thrombocytopenia: a systematic review of current reports

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