Clinical characteristics, management and outcome of COVID‐19‐associated immune thrombocytopenia: a French multicentre series

Mahévas, Matthieu; Moulis, Guillaume; Andrès, Emmanuel; Rivière, Étienne; Garzaro, Margaux; Crickx, Étienne; Guillotin, Vivien; Malphettes, Marion; Galicier, Lionel; Noël, Nicolas; Darnige, Luc; Terriou, Louis; Guerveno, Claire; Sanchis-Borja, Mateo; Moulinet, T.; Meunier, B.; Ebbo, Mikaël; Michel, Marc; Godeau, Bertrand

doi:10.1111/bjh.17024

Cited by 84 publications

(102 citation statements)

References 21 publications

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“…Among these 5 patients, one was negative for COVID-19 at ITP onset [7]. In the French multicenter series [14], SARS-CoV-2 was negative at ITP onset in 2 patients. Data have been presented in Table 2.…”

Section: Demographic Profile and Baseline Characteristicsmentioning

confidence: 89%

“…Among symptomatic patients with available data (N = 39), median day from onset of COVID-19 symptoms to diagnosis of ITP was 13 days, with majority reported in the second and third week. Median nadir platelet count was 5 × 10 9 /L; only 7 patients (15.5%) had nadir count more than 20 × 10 9 /L [14,17,23,24,28]. Secondary Evans syndrome, as evident by concomitant hemolytic anemia, was diagnosed in one case [29].…”

Section: Itp Onset and Bleeding Manifestationsmentioning

confidence: 96%

“…Among other forms of bleeding, epistaxis was commonest. Intracranial hemorrhage was diagnosed in 4 patients [11,14,23,26]. Among them, only one mortality has been reported [11].…”

Section: Itp Onset and Bleeding Manifestationsmentioning

confidence: 99%

“…Glucocorticoids were used alone in 22% cases and in combination with IVIG in 24.5% cases. Thrombopoietin receptor agonists (TP-RA) were used [14,17] or both IVIG and glucocorticoids [14,23,26]. In one patient, TP-RA was used alone when IVIG was discontinued owing to the development of acute heart failure [17].…”

Section: Treatment and Clinical Outcomesmentioning

confidence: 99%

“…A total of 3 individuals expired: one was due to intracranial hemorrhage [11] and others succumbed to severity of COVID-19 illness after showing platelet response to treatment [15,27]. A total of 4 patients (9%) had relapse following treatment response in the followup period [13,14]. Among patients with available individual data, median days to response and complete response were 5 and 8 days, respectively.…”

Section: Treatment and Clinical Outcomesmentioning

confidence: 99%

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Immune Thrombocytopenia Secondary to COVID-19: a Systematic Review

Bhattacharjee

Banerjee

2020

SN Compr. Clin. Med.

262

325

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Immune thrombocytopenia, often known as immune thrombocytopenic purpura (ITP), has emerged as an important complication of COVID-19. A systematic review was done to analyze the clinical profile and outcomes in a total of 45 cases of new-onset ITP in COVID-19 patients described in literature until date. A comprehensive approach is essential for diagnosing COVID-19associated ITP after excluding several concomitant factors that can cause thrombocytopenia in COVID-19. Majority of ITP cases (71%) were found to be elderly (> 50 years) and 75% cases had moderate-to-severe COVID-19. Three patients (7%) were in the pediatric age group. Reports of ITP in asymptomatic COVID-19 patients (7%) underscore the need for COVID-19 testing in newly diagnosed patients with ITP irrespective of COVID-19 symptoms amid this pandemic. ITP onset occurred in 20% cases 3 weeks after onset of COVID-19 symptoms, with many reports after clinical recovery. SARS-CoV-2-mediated immune thrombocytopenia can be attributed to the underlying immune dysregulation, susceptibility mutations in SOCS 1, and other mechanisms, including molecular mimicry, cryptic antigen expression, and epitope spreading. No bleeding manifestations were reported in 31% cases at diagnosis. Severe life-threatening bleeding was uncommon. One case of mortality was attributed to intracranial hemorrhage. Secondary Evans syndrome was diagnosed in one case. Good initial response to short course of glucocorticoids and intravenous immunoglobulin has been found with the exception of delayed lag response in one case. Thrombopoietin receptor agonist usage as a second-line agent has been noted in few cases for short duration with no adverse events. In the relatively short follow-up period, four relapses of ITP were found.

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Section: Demographic Profile and Baseline Characteristicsmentioning

confidence: 89%

Section: Itp Onset and Bleeding Manifestationsmentioning

confidence: 96%

“…Among other forms of bleeding, epistaxis was commonest. Intracranial hemorrhage was diagnosed in 4 patients [11,14,23,26]. Among them, only one mortality has been reported [11].…”

Section: Itp Onset and Bleeding Manifestationsmentioning

confidence: 99%

Section: Treatment and Clinical Outcomesmentioning

confidence: 99%

Section: Treatment and Clinical Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

Immune Thrombocytopenia Secondary to COVID-19: a Systematic Review

Bhattacharjee

Banerjee

2020

SN Compr. Clin. Med.

262

325

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Thrombocytopenia following Pfizer and Moderna SARS‐CoV‐2 vaccination

et al. 2021

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Late‐onset hematological complications post COVID‐19: An emerging medical problem for the hematologist

et al. 2021

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Coronavirus disease 19 (COVID‐19) is considered a multisystemic disease. Several studies have reported persistent symptoms or late‐onset complications after acute COVID‐19, including post‐COVID‐19 hematological disorders. COVID‐19‐induced coagulopathy, an immunothrombotic state, has been linked to thromboembolic and hemorrhagic events. Late‐onset thrombocytopenia related to immune system dysregulation has also been reported as a rare manifestation post COVID‐19. Close monitoring of laboratory dynamics is considered essential to identify timely abnormal values that need further investigation, providing supportive care whenever indicated. The role of hematologists is essential in terms of the multidisciplinary approach of long COVID‐19. This review summarizes all the available evidence on post‐acute COVID‐19 hematological complications.

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Clinical characteristics, management and outcome of COVID‐19‐associated immune thrombocytopenia: a French multicentre series

Cited by 84 publications

References 21 publications

Immune Thrombocytopenia Secondary to COVID-19: a Systematic Review

Immune Thrombocytopenia Secondary to COVID-19: a Systematic Review

Thrombocytopenia following Pfizer and Moderna SARS‐CoV‐2 vaccination

Late‐onset hematological complications post COVID‐19: An emerging medical problem for the hematologist

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