Frequently Relapsing Post-COVID-19 Immune Thrombocytopenia

Serrano, Claudia; Español, Ignacio; Cascales, Almudena; Moraleda, J.

doi:10.1007/s42399-021-01019-7

Cited by 11 publications

(11 citation statements)

References 6 publications

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“…On the other side, pure ITP seems to be due to platelet destruction for the cross‐reaction between the anti‐COVID‐19 IgG and the platelet membrane components. If this immune dysregulation occurs, the response to corticosteroids and Ig could be favourable, like in our experience and in other cases reported in literature [2–7]. The practical guidance for the management of adult ITP during the COVID‐19 pandemic also endorses this evidence.…”

Section: Number Of Patients 17supporting

confidence: 82%

“…Since the start of the novel pandemic caused by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV2), known as COVID‐19, different cases of ITP in infected subjects have been reported from all over the world. Most of these reports are describing newly diagnosed ITP (ND‐ITP) in COVID‐19 patients [ 2 , 3 , 4 , 5 , 6 , 7 ]; some authors also report subjects with chronic ITP infected with SARS‐CoV2, either relapsing or not [ 8 , 9 ].…”

Section: Tablementioning

confidence: 99%

See 1 more Smart Citation

Immune thrombocytopenia management during COVID‐19 pandemic: An Italian monocentric experience

Lapietra

Ferretti

Baldacci

et al. 2022

eJHaem

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Over the last 2 years, different cases of immune thrombocytopenia (ITP) in patients affected by SARS‐CoV2 have been reported. The management of SARS‐CoV2 in subjects with simultaneous or previous ITP can be challenging because of the great involvement of the haemostatic system in this viral infection. In this report, we describe the management and outcome of patients with newly diagnosed (ND), chronic and previous ITP, infected by COVID‐19, referred to the Haematology Institute of University Hospital Policlinico Umberto I in Rome. Steroids + immunoglobulins for ND or relapsed ITP and continuation of home therapy for chronic ITP are advised, although further knowledge is required.

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Section: Number Of Patients 17supporting

confidence: 82%

Section: Tablementioning

confidence: 99%

Immune thrombocytopenia management during COVID‐19 pandemic: An Italian monocentric experience

Lapietra

Ferretti

Baldacci

et al. 2022

eJHaem

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“…In another study, a young COVID-19 positive woman who delivered a stillbirth at 29 weeks into gestation was also diagnosed with thrombotic thrombocytopenic purpura [35]. Interestingly, new-onset immune thrombocytopenia post-mild COVID-19 has been reported during the pandemic [36], and also following Pfizer-BioNTech vaccination [37], which indicates that the etiology of this condition is more complex than can be explained by the adenoviral vectors alone.…”

Section: Viral Vector Covid-19 Vaccinesmentioning

confidence: 99%

Maternal COVID-19 Vaccination and Its Potential Impact on Fetal and Neonatal Development

et al. 2021

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Vaccines have been developed at “warp speed” to combat the COVID-19 pandemic caused by the SARS-CoV-2 coronavirus. Although they are considered the best approach for preventing mortality, when assessing the safety of these vaccines, pregnant women have not been included in clinical trials. Thus, vaccine safety for this demographic, as well as for the developing fetus and neonate, remains to be determined. A global effort has been underway to encourage pregnant women to get vaccinated despite the uncertain risk posed to them and their offspring. Given this, post-hoc data collection, potentially for years, will be required to determine the outcomes of COVID-19 and vaccination on the next generation. Most COVID-19 vaccine reactions include injection site erythema, pain, swelling, fatigue, headache, fever and lymphadenopathy, which may be sufficient to affect fetal/neonatal development. In this review, we have explored components of the first-generation viral vector and mRNA COVID-19 vaccines that are believed to contribute to adverse reactions and which may negatively impact fetal and neonatal development. We have followed this with a discussion of the potential for using an ovine model to explore the long-term outcomes of COVID-19 vaccination during the prenatal and neonatal periods.

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“…Table 1 compares our patient's case with seven other reported cases of relapsing ITP following COVID-19 infection [15][16][17][18]. Our patient was significantly younger than the other seven patients, who ranged in age from 53 to 74 years.…”

Section: Discussionmentioning

confidence: 79%

“…There was no gender predominance (four male, four female), and none of the patients were reported to have concurrent autoimmune diseases. The interval between the time of COVID-19 infection and initial diagnosis of thrombocytopenia ranged from zero to eight weeks [ 16 , 17 ], and three of the eight patients were diagnosed with ITP before they became symptomatic, presumably by routine lab testing while they were hospitalized. Our patient was not admitted to the hospital during her COVID-19 infection and was diagnosed with ITP only when she developed symptoms eight weeks later.…”

Section: Discussionmentioning

confidence: 99%

Persistent Relapsing Immune Thrombocytopenia Following COVID-19 Infection

Boehm¹,

Packer²

2022

Cureus

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Immune thrombocytopenia (ITP) is a rare autoimmune disease that presents along a spectrum of disease severity, ranging from asymptomatic thrombocytopenia to potentially life-threatening bleeding complications. Recent case reports and case series suggest that a COVID-19 infection can trigger secondary ITP and may be associated with higher rates of bleeding and lower nadir platelet counts compared to patients with ITP of other etiologies. Multiple ITP relapses have also been described in some COVID-19 patients. We report the case of a 30-year-old otherwise healthy woman who presented to the hospital with fatigue, easy bruising, and a platelet count of 11 x 10 3 /µL. She responded well to our initial treatment with prednisone and intravenous immunoglobulin (IVIG) but experienced a persistent disease course with nine ITP relapses (defined as platelet count <30 x 10 3 /µL) over the next 10.5 months, requiring six additional hospital admissions for acute management as well as long-term maintenance medication adjustments. It is important for clinicians to recognize ITP as a potential complication of a COVID-19 infection and to initiate early therapy to prevent serious bleeding in these patients. Further studies will be needed to understand the natural history, optimal treatment, and prognosis for patients with relapsing COVID-19-associated ITP.

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Frequently Relapsing Post-COVID-19 Immune Thrombocytopenia

Cited by 11 publications

References 6 publications

Immune thrombocytopenia management during COVID‐19 pandemic: An Italian monocentric experience

Immune thrombocytopenia management during COVID‐19 pandemic: An Italian monocentric experience

Maternal COVID-19 Vaccination and Its Potential Impact on Fetal and Neonatal Development

Persistent Relapsing Immune Thrombocytopenia Following COVID-19 Infection

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