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Impact of COVID-19 Pandemic on Patients with Immune Thrombocytopaenia
Román, MÁ, Jiménez Yuste, V., García Barcenilla, S., Ramírez López, A., Monzón Manzano, E., de la Cruz Benito, B., Butta, P. A., Rivas Pollmar, M. I., Trelles Martínez, R., González Zorrilla, E., et al
Medicina (Kaunas, Lithuania). 2021;57(3)
Abstract
Background and Objectives: The aim of this study was to determine the impact of the COVID-19 pandemic on the lives of patients with immune thrombocytopaenia (ITP) treated at our hospital. Materials and Methods: The study was conducted in the Community of Madrid, which has the highest number of COVID-19 cases in Spain. We included 143 adult patients with ITP (130 with chronic ITP, 8 with persistent ITP, and 5 with newly diagnosed ITP). We conducted a telephone survey to collect the data and created a registry. Materials and Methods: Overall, 24 patients presented symptoms suggestive of COVID-19, which was confirmed by RT-PCR in 8 cases. The cumulative incidence of confirmed SARS-CoV-2 infection was higher in the patients with ITP than in the Madrid population. There were no differences in the disease incidence or clinical course of infection in the patients treated with immunosuppressants. Almost all of the patients reported adherence to the prescribed treatment, although 49.2% of the hospital visits were either cancelled or postponed, 17.2% because of the patients' fear of coming to the centre. Nearly half of the cohort was considered vulnerable, and 17% had been granted a dependency or disability benefit. Conclusions: COVID-19 had a major impact on the psychosocial, occupational, and quality of care of patients with ITP.
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Purpuric Rash and Thrombocytopenia After the mRNA-1273 (Moderna) COVID-19 Vaccine
Malayala, S. V., Mohan, G., Vasireddy, D., Atluri, P.
Cureus. 2021;13(3):e14099
Abstract
The mRNA-1273 vaccine, popularly called the "Moderna vaccine" is being widely administered in the United States for the prevention of COVID-19 infection since December 2020. Mild to moderate intensity side effects like low-grade fever, myalgia, chills and malaise were reported in the trials related to the vaccine. With this case report, we report a case of purpuric rash and thrombocytopenia after receiving the first dose of the m-RNA-1273 vaccine. The patient, in this case, is a 60-year-old male patient who received the first vaccine dose and within two days, he developed diffuse papular rash associated with some thrombocytopenia. He had a history of tobacco use, Hepatitis C liver cirrhosis, chronic kidney disease stage 4, untreated hypertension and systolic congestive heart failure at the baseline. With review of the limited literature related to the vaccine and its side effect profile and with no other etiology explaining the sudden onset of rash, we attribute this thrombocytopenia and purpuric rash as the side effects of the mRNA-1273 vaccine.
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3.
Thrombocytopenia in Virus Infections
Raadsen, M., Du Toit, J., Langerak, T., van Bussel, B., van Gorp, E., Goeijenbier, M.
Journal of Clinical Medicine. 2021;10(4)
Abstract
Thrombocytopenia, which signifies a low platelet count usually below 150 × 10(9)/L, is a common finding following or during many viral infections. In clinical medicine, mild thrombocytopenia, combined with lymphopenia in a patient with signs and symptoms of an infectious disease, raises the suspicion of a viral infection. This phenomenon is classically attributed to platelet consumption due to inflammation-induced coagulation, sequestration from the circulation by phagocytosis and hypersplenism, and impaired platelet production due to defective megakaryopoiesis or cytokine-induced myelosuppression. All these mechanisms, while plausible and supported by substantial evidence, regard platelets as passive bystanders during viral infection. However, platelets are increasingly recognized as active players in the (antiviral) immune response and have been shown to interact with cells of the innate and adaptive immune system as well as directly with viruses. These findings can be of interest both for understanding the pathogenesis of viral infectious diseases and predicting outcome. In this review, we will summarize and discuss the literature currently available on various mechanisms within the relationship between thrombocytopenia and virus infections.
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Thrombocytopenia following Pfizer and Moderna SARS/CoV-2 vaccination
Lee, E. J., Cines, D. B., Gernsheimer, T., Kessler, C., Michel, M., Tarantino, M. D., Semple, J. W., Arnold, D. M., Godeau, B., Lambert, M. P., et al
American Journal of Hematology. 2021
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Immune thrombocytopenia during the COVID-19 pandemic
Lee, E. J., Liu, X., Hou, M., Bussel, J. B.
British journal of haematology. 2021
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Severe Thrombocytopenia in a Pregnant Patient with Asymptomatic COVID-19 Infection: A Case Report
Moses, M. L., Kazzi, N. G., Lee, L.
Cureus. 2021;13(1):e12990
Abstract
Thrombocytopenia occurs in one-third of patients with coronavirus disease 2019 (COVID-19) infection and can indicate the severity of disease and may also increase the bleeding risk of performing invasive procedures. We present a pregnant patient with COVID-19 infection with the lowest platelet count described in the literature to date. The patient presented in labor at 38 weeks gestation with no other symptoms and was found to be positive on routine COVID-19 testing. The routine complete blood count upon admission was significant for a platelet count of 6 x 10(9)/L which was rechecked and resulted in a platelet count of 8 x 10(9)/L. The etiology of her thrombocytopenia was not clear prior to delivery as preeclampsia with severe features and lupus exacerbation were also possibilities that were considered. However, after delivery it became apparent that COVID-19 likely had a significant impact contributing to her severe thrombocytopenia. Her care was complicated by postpartum hemorrhage resulting in massive transfusion. This case highlights the importance of evaluating platelet count and coagulation status in COVID-19 patients, even if asymptomatic.
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Thrombotic Thrombocytopenia after Ad26.COV2.S Vaccination
Muir, K. L., Kallam, A., Koepsell, S. A., Gundabolu, K.
The New England journal of medicine. 2021
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COVID-19 associated thrombotic thrombocytopenic purpura (TTP) ; A case series and mini-review
Tehrani, H. A., Darnahal, M., Vaezi, M., Haghighi, S.
International Immunopharmacology. 2021;93:107397
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Abstract
INTRODUCTION Thrombotic microangiopathies are a group of disorders that are mainly related to endothelial dysfunction. This category of endothelial dysfunction results of several imbalances between platelets, endothelium and immune system, also cytokine production. AIM OF THIS STUDY To report cases with thrombotic thrombocytopenic purpura (TTP) and COVID-19 and review COVID-19 endothelial dysfunction literature. METHODS Primary laboratory data, peripheral blood smear, ADAMTS13 antigen activity level, and antibody ordered for each of these four patients. Treatments for COVID-19 administered for all patients. Traditional treatments for TTP also were administered. RESULTS There were numerous schistocytes (more than 5%) in peripheral blood smears for each patient. ADAMTS13 antigen activity level was below 10%, and ADAMTS13 antibody was elevated for each patient. COVID-19 PCR was positive for all patients, and CT-Scans were indicative of the involvement of COVID-19. CONCLUSION In this case series, we reported four COVID-19 patients who presented with signs and symptoms of anemia and thrombocytopenia, resulting in thrombotic thrombocytopenic purpura.
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Immune Thrombocytopenia in a 22-Year-Old Post Covid-19 Vaccine
Tarawneh, O. H., Tarawneh, H. S.
American Journal of Hematology. 2021
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Increased prevalence of heparin induced thrombocytopenia in COVID-19 patients
Preti, P. S., Russo, M., Caneva, L., Reduzzi, M., Calabretta, F., Spataro, C., Grimaldi, P., De Amici, M., Testa, G., Iotti, G. A., et al
Thrombosis Research. 2021;203:33-35
