Paediatric Hospitalised Immune Thrombocytopenia in Real-Life Recent Viral Infection Outbreaks: A Retrospective Study

Area of Science:

• Immunology
• Virology
• Pediatrics

Background:

• Immune thrombocytopenia (ITP) is an autoimmune condition frequently linked to preceding viral infections.
• Platelets are increasingly recognized for their active role in viral interactions, moving beyond the bystander hypothesis.
• Understanding the interplay between viral outbreaks and ITP incidence is crucial for public health management.

Purpose of the Study:

• To investigate the impact of viral infections on the incidence and outcomes of immune thrombocytopenia (ITP) in children.
• To compare ITP cases during a viral outbreak period with an epidemic-free period.
• To identify specific viral triggers associated with increased ITP diagnoses.

Main Methods:

• A descriptive, observational, retrospective cohort study was conducted.
• Data from newly diagnosed ITP cases over a 10-year period were analyzed.
• Two groups were compared: a viral outbreak period (2020-2024) and an epidemic-free period (2015-2019).

Main Results:

• A significant increase in the number and incidence of newly diagnosed ITP cases in hospitalized children was observed during the viral outbreak period (p=0.05 and p=0.001, respectively).
• This rise was strongly associated with infections such as severe acute respiratory syndrome coronavirus 2 (r=0.967, p=0.007), Epstein-Barr virus (r=0.974, p=0.004), and influenza (r=0.901, p=0.037).
• The severity and chronicity of ITP remained consistent between the periods, with a trend towards mild thrombocytopenia (p=0.028).

Conclusions:

• Viral infections, particularly during outbreaks, significantly elevate the incidence of pediatric ITP.
• Despite unchanged severity, the increased ITP cases pose a considerable healthcare cost burden.
• Implementing preventive measures during high-risk viral infection periods is essential to mitigate ITP incidence.