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Suspicion of heparin-induced thrombocytopenia in COVID-19: Results from a multi-centric retrospective study
Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509009
ABSTRACT

Background:

High rates of venous thromboembolic events associated to LMWH/heparin therapy lead to numerous heparin-induced thrombocytopenia (HIT) suspicion during COVID-19 outbreak.

Aims:

We aim to describe HIT-suspected patient's characteristics and prevalence between March 15 and April 15 of 2020.

Methods:

This is a multi-centric retrospective cohort study of HITsuspected patients referred to our center. 4T score has been realized by experienced hematologist and/or pharmacologist and allowed us to trigger specific HIT assays if score was >3 (IgG anti-PF4/H and 14C-serotonine release assay, SRA). We included all consecutive HIT-suspected patients during COVID-19 outbreak compared to the same period in 2019.

Results:

During 2019 and 2020-study periods we identified, respectively, 17 and 41 consecutive HIT-suspected patients. Among the 2020-group, 23 were COVID-19 and 18 were non-COVID-19 patients. Clinical and biological characteristics were not significantly different between the 2019, 2020 non-COVID-19 and COVID-19 HIT-suspected patients. During 2019-period study, 11 (64.7%) patients had a 4T score >3, 4 (36.3%) of them had positive anti-PF4/H antibodies and only one had a positive SRA assay. During 2020-period study, 8 (44.4%) non-COVID-19 and 10 (43.5%) COVID-19 patients had a 4T score >3. Among them, respectively, 3 (37.5%) and 3 (30.%) had positive anti-PF4/H antibodies. SRA assay was positive in 3 non-COVID-19 patients tested and in the only one COVID-19 tested patient. The 4T score was able to exclude HIT in 67% of COVID-19 patients suspected. In 2020-study period, when comparing COVID-19 and non-COVID-19 patients, the only significantly difference in term of HIT suspicion criteria was the mean duration of heparin exposition before suspicion 9.9 days ±6.3 for non-COVID-19 patients versus 15.2 days ±8.8 for COVID-19 patients, P = 0.043).

Conclusions:

HIT suspicion in COVID-19 occurs after longer anticoagulation time than non-COVID-19. We did not observe more confirmed HIT in COVID-19 in contrast our two non-COVID-19 control groups.

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study Language: English Journal: Research and Practice in Thrombosis and Haemostasis Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study Language: English Journal: Research and Practice in Thrombosis and Haemostasis Year: 2021 Document Type: Article