The complicated relationships of heparin-induced thrombocytopenia and platelet factor 4 antibodies with COVID-19.
Int J Lab Hematol
; 43(4): 547-558, 2021 Aug.
Article
in English
| MEDLINE | ID: covidwho-1231132
ABSTRACT
COVID-19 (coronavirus disease 2019) represents a prothrombotic disorder, and there have been several reports of platelet factor 4/heparin antibodies being present in COVID-19-infected patients. This has thus been identified in some publications as representing a high incidence of heparin-induced thrombocytopenia (HIT), whereas in others, findings have been tempered by general lack of functional reactivity using confirmation assays of serotonin release assay (SRA) or heparin-induced platelet aggregation (HIPA). Moreover, in at least two publications, data are provided suggesting that antibodies can arise in heparin naïve patients or that platelet activation may not be heparin-dependent. From this literature, we would conclude that platelet factor 4/heparin antibodies can be observed in COVID-19-infected patients, and they may occur at higher incidence than in historical non-COVID-19-infected cohorts. However, the situation is complex, since not all platelet factor 4/heparin antibodies may lead to platelet activation, and not all identified antibodies are heparin-dependent, such that they do not necessarily reflect "true" HIT. Most recently, a "HIT-like" syndrome has reported in patients who have been vaccinated against COVID-19. Accordingly, much more is yet to be learnt about the insidious disease that COVID-19 represents, including autoimmune outcomes in affected patients.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Thrombocytopenia
/
Platelet Factor 4
/
Heparin
/
COVID-19
/
Antibodies
/
Anticoagulants
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Animals
/
Humans
Language:
English
Journal:
Int J Lab Hematol
Journal subject:
Hematology
Year:
2021
Document Type:
Article
Affiliation country:
Ijlh.13582
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