Heparin-induced thrombocytopenia and COVID-19

Abstract

Heparin-induced thrombocytopenia (HIT) has not been included as a possible cause of thrombocytopenia in Coronavirus Disease 2019 (COVID-19) patients. We report a case of HIT in a patient with COVID-19 treated with heparin. A 78-yearold man was admitted to our hospital for acute respiratory failure and acute renal failure due to SARS-CoV-2 infection; in intensive care unit, one 5000IU heparin dose (day 0, platelet count 305000/μL). On day 2, haemoglobin started to decrease and heparin was stopped. On day 10, platelet count was 153000/μL and 5000IU calcium heparin subcutaneously twice daily was started. The platelet further decreased, reaching 49000/μL on day 17, and the patient was investigated for suspected HIT: an IgG specific chemiluminescence test for heparin- PF4 antibodies was positive and a femoral DVT was found at ultrasound. Argatroban was started, platelet count increased without any bleeding and thrombosis complication. Our experience shows that HIT may develop in heparin treated COVID-19 patients and should be included among the possible cause of thrombocytopenia in such patients.

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Published
2021-03-12
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Case Reports
Keywords:
Heparin-induced thrombocytopenia, COVID-19, deep vein thrombosis, heparin, SARS-CoV-2, thrombocytopenia
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How to Cite
Sartori, M., & Cosmi, B. (2021). Heparin-induced thrombocytopenia and COVID-19. Hematology Reports, 13(1). https://doi.org/10.4081/hr.2021.8857