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Case Report

Heparin-Induced Thrombocytopenia and COVID-19

by
Michelangelo Sartori
1,* and
Benilde Cosmi
1,2
1
Division of Angiology and Blood Coagulation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
2
University of Bologna, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2021, 13(1), 8857; https://doi.org/10.4081/hr.2021.8857
Submission received: 23 August 2020 / Revised: 7 October 2020 / Accepted: 30 October 2020 / Published: 12 March 2021

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-year-old 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 5000 IU heparin dose (day 0, platelet count 305,000/μL). On day 2, haemoglobin started to decrease and heparin was stopped. On day 10, platelet count was 153,000/μL and 5000 IU calcium heparin subcutaneously twice daily was started. The platelet further decreased, reaching 49,000/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.
Keywords: heparin-induced thrombocytopenia; COVID-19; deep vein thrombosis; heparin; SARS-CoV-2; thrombocytopenia heparin-induced thrombocytopenia; COVID-19; deep vein thrombosis; heparin; SARS-CoV-2; thrombocytopenia

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MDPI and ACS Style

Sartori, M.; Cosmi, B. Heparin-Induced Thrombocytopenia and COVID-19. Hematol. Rep. 2021, 13, 8857. https://doi.org/10.4081/hr.2021.8857

AMA Style

Sartori M, Cosmi B. Heparin-Induced Thrombocytopenia and COVID-19. Hematology Reports. 2021; 13(1):8857. https://doi.org/10.4081/hr.2021.8857

Chicago/Turabian Style

Sartori, Michelangelo, and Benilde Cosmi. 2021. "Heparin-Induced Thrombocytopenia and COVID-19" Hematology Reports 13, no. 1: 8857. https://doi.org/10.4081/hr.2021.8857

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