Heparin‐induced thrombocytopenia with thrombosis in COVID‐19 adult respiratory distress syndrome
| Autor: | Gilles L. Fraser, David R. Gagnon, David B. Seder, Richard R. Riker, Mahesh Bandara, Teresa May, Wesley R. Zemrak |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
coronavirus Case Report heparin/ adverse effects Case Reports Internal medicine Heparin-induced thrombocytopenia Medicine thrombocytopenia / chemically induced Platelet thrombosis Respiratory distress business.industry lcsh:RC633-647.5 Incidence (epidemiology) heparin / adverse effects adult Hematology Heparin lcsh:Diseases of the blood and blood-forming organs medicine.disease thrombocytopenia/chemically induced Thrombosis Pulmonary embolism respiratory distress syndrome business Platelet factor 4 medicine.drug |
| Zdroj: | Research and Practice in Thrombosis and Haemostasis Research and Practice in Thrombosis and Haemostasis, Vol 4, Iss 5, Pp 936-941 (2020) |
| ISSN: | 2475-0379 |
| DOI: | 10.1002/rth2.12390 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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