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COVID-19 Presenting With a Challenging Combination of Thrombocytopenia and Thrombosis

Swapna Ravi1, Sushmita Khadka2, Charumathi Subrahmanian Raghu3

  • 1Department of Internal Medicine, St. Luke's Internal Medicine Associates, Duluth, MN, USA.

Journal of Medical Cases
|April 25, 2022
PubMed

Insights

COVID-19 can cause serious blood disorders like thrombocytopenia and coagulopathy. These cases highlight the complex hematological challenges and high mortality associated with severe COVID-19 infections.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • COVID-19 (Coronavirus disease 2019) is associated with diverse hematological abnormalities.
  • These abnormalities can lead to significant complications during the disease course.

Observation:

  • Two cases of COVID-19 presenting with combined thrombocytopenia and coagulopathy are described.
  • Case 1: A 73-year-old male with a history of immune thrombocytopenic purpura (ITP) experienced acute ischemic stroke and thrombocytopenia during COVID-19.
  • Case 2: A 72-year-old female with liver cirrhosis and chronic thrombocytopenia developed deep venous thrombosis (DVT) and retroperitoneal hemorrhage during COVID-19.

Findings:

  • Both patients were managed with steroids and intravenous immunoglobulin (IVIG).
  • The first patient suffered a subsequent ischemic stroke with microhemorrhages.
  • The second patient experienced a fatal retroperitoneal hemorrhage despite anticoagulation and inferior vena cava filter placement.

Implications:

  • Severe COVID-19 presents significant management challenges due to limited treatment options and high mortality.
  • These cases underscore the critical need for further research into managing COVID-19-associated hematological complications.
  • Understanding these complex interactions is crucial for improving patient outcomes in the ongoing pandemic.

Keywords:
COVID-19CoagulopathyThrombocytopeniaThrombosis

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