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Updated: Sep 5, 2025

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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Ischemic Stroke Due to Heparin-induced Thrombocytopenia during Severe COVID-19 Infection

Yasutaka Murakami1, Shuhei Okazaki1, Makoto Yamamoto2

  • 1Department of Neurology, Osaka University Graduate School of Medicine, Japan.

Internal Medicine (Tokyo, Japan)
|July 6, 2022
PubMed

A 53-year-old woman with severe coronavirus disease 2019 (COVID-19) pneumonia was admitted and treated with intravenous unfractionated heparin for thromboprophylaxis under general anesthesia with mechanical ventilation. She developed right hemiparesis after hospitalization due to a large hemorrhagic infarction. Her platelet count decreased from 243,000/μL at administration to 121,000/μL. Anti-platelet factor 4-heparin antibody testing was positive according to a latex immunoturbidimetric assay. She was therefore diagnosed with heparin-induced thrombocytopenia. We immediately stopped the heparin and started argatroban; the platelet count recovered, and thrombosis did not relapse. Physicians should consider heparin-induced thrombocytopenia as a cause of ischemic stroke in patients with COVID-19 infection.

Keywords:
COVID-19heparin-induced thrombocytopeniaischemic stroke

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