Heparin induced thrombocytopenia before and during COVID-19 pandemia in Iran

ABSTRACT

Background: The patients with COVID-19 disease are at high risk for thrombosis. More aggressive thromboprophylaxis anticoagulation are considered in these patients. Several reports indicates a higher HIT incidence in the patients with COVID-19 than other medical patients, Aims: We conducted this study to evaluate the frequency of HIT among patients with COVID-19 in comparison with non-COVID- 19 patients. Method(s) The study population included patients who referred to the Iranian blood transfusion organization (IBTO) reference coagulation laboratory for anti-PF4/ H Ab testing (LFIA method, STic EXPERT, STAGO) during a 30 months period before and after the COVID-19 pandemic in Iran. On 19 February 2020, Iran reported its first confirmed cases of infections in Qom. The patients have been divided into three groups Group1, Sep 2019-Feb 2020 (before COVID-19 pandemic in Iran), group 2 March 2020-Aug 2020 (the first and second peaks), group 3 Sep2020-Feb 2021 (the third and fourth peaks). The demographic data;4Ts score, Anti PF4-Ab (LIFA), and HIPA test results were evaluated. The HIPA test was checked in cases with the positive result of LFIA test. Result(s) A total number of 110 patients have been referred for anti- PF4 Ab testing to our laboratory center during a 30 months period with the detail in table 1and 2. The rate of positive LFIA was 10 % and 33% in the non-Covid- 19 and Covid-19 patients respectively (OR = 4.1%, 95% CI, P-value 0.022). HIPA test was assessed in 4 cases of Covid-19 and all were positive (definitive HIT). Conclusion(s) Among 110 referral cases in 30 months period who were referred for Anti PF4/H Ab testing to our lab, 94 ( 85%) of cases were referred during the first year of the Covid-19 pandemic in Iran. Regarding the rate of definite HIT (>=16%) among Covid-19 patients, our data confirm the high rate of HIT in this group of patients. (Table Presented).