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

Immune thrombocytopenia (ITP) is an autoimmune disorder often triggered by prior viral infections. Although there is considerable evidence suggesting platelets act as passive bystanders during viral illnesses, they are increasingly recognised as active participants in their interactions with viruses. Our descriptive observational retrospective study, conducted at a tertiary hospital in Romania, aimed to evaluate the impact of viral infections on the incidence and outcomes of ITP. This cohort study focused on newly diagnosed ITP cases over a 10-year period, comparing two patient groups: the first group (I-306 patients) from the viral outbreak period (2020-2024) and the second (II-213 patients) from an epidemic-free period (2015-2019). Despite non-pharmacological measures implemented to prevent respiratory infection spread, the number (p = 0.05) and incidence (p = 0.001) of newly diagnosed ITP cases in hospitalised children increased significantly, mainly associated with 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), with mild thrombocytopenia (p = 0.028). The severity and persistence or chronicity of ITP remained unchanged. The rise in newly diagnosed ITP cases, even without increased severity or chronic evolution, may impose a substantial burden of medical and non-medical costs, highlighting the need for preventive measures during risky viral infection outbreaks.