Persistent Immune Thrombocytopenia as a Post-Acute Sequelae of COVID-19: A Case Report

Immune thrombocytopenia (ITP) is a recognized hematologic complication associated with coronavirus disease 2019 (COVID-19), but its persistence years after acute infection remains uncommon. We present a case of a 52-year-old male who was diagnosed with COVID-19 in June 2020. Following recovery from the acute illness, he had persistent fatigue, reduced energy levels, and poor appetite. Laboratory testing at his first follow-up revealed thrombocytopenia with a platelet count of 60,000/mm³. He had no bleeding manifestations or organomegaly. A trial of oral corticosteroids in a tapering dose produced a partial response, with the platelet count rising to 94,000/mm³. Subsequently, a bone marrow biopsy was performed, confirming the diagnosis of ITP, excluding infiltration and dysplasia. Over the following 5 years, the patient continued to demonstrate persistent thrombocytopenia requiring a close clinical monitoring and follow-up. This case highlights persistent ITP as a long-term sequela of COVID-19, extending more than 4 years after the initial infection. It underscores the importance of considering post-COVID hematologic complications in patients presenting with chronic thrombocytopenia and emphasizes the need for ongoing surveillance and individualized management strategies.