Heparin-induced thrombocytopenia with thrombosis in COVID-19 adult respiratory distress syndrome.
Res Pract Thromb Haemost
; 4(5): 936-941, 2020 Jul.
Article
in English
| MEDLINE | ID: covidwho-324267
ABSTRACT
Early reports of coronavirus disease 2019 (COVID-19) clinical features describe a hypercoagulable state, and recent guidelines recommend prophylactic anticoagulation for patients with COVID-19 with low-molecular-weight heparin, but this would be contraindicated in the presence of heparin-induced thrombocytopenia (HIT). We address the key clinical question whether HIT is also present during COVID-19. We report 3 cases of thrombocytopenia with antiplatelet factor 4 antibodies among 16 intubated patients with COVID-19 with adult respiratory distress syndrome, a higher-than-expected incidence of 19%. Each patient had evidence of thrombosis (pulmonary embolism, upper extremity venous thromboses, and skin necrosis, respectively). The serotonin release assay confirmed HIT in 1 case, and 2 cases were negative. We believe this is the first reported case of HIT during the COVID-19 pandemic. Recognition that the thrombocytopenia represented HIT in the confirmed case was delayed. We recommend clinicians monitor platelet counts closely during heparin therapy, with a low threshold to evaluate for HIT.
Full text:
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Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
/
Experimental Studies
/
Observational study
/
Prognostic study
Language:
English
Journal:
Res Pract Thromb Haemost
Year:
2020
Document Type:
Article
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