COVID-19-Associated Thrombotic Thrombocytopenic Purpura: A Case Report and Systematic Review.

Authors

Haseeb Chaudhary, Department of Internal Medicine, Reading Hospital-Tower Health, Reading, PA 19611, USA
Usama Nasir, Department of Internal Medicine, Reading Hospital-Tower Health, Reading, PA 19611, USAFollow
Khezar Syed, Department of Internal Medicine, Reading Hospital-Tower Health, Reading, PA 19611, USA
Maria Labra, Department of Internal Medicine, Reading Hospital-Tower Health, Reading, PA 19611, USAFollow
Christopher Reggio, Department of Internal Medicine, Reading Hospital-Tower Health, Reading, PA 19611, USAFollow
Ansar Aziz, Department of Hospital Medicine, Reading Hospital, Reading, PA 19611, USA.Follow
Parin Shah, Department of Pulmonary and Critical Care, Reading Hospital, Reading, PA 19611, USAFollow
Roopika Reddy, Department of Pulmonary and Critical Care, Reading Hospital, Reading, PA 19611, USAFollow
Navdeep Sangha, Department of Hematology and Oncology, Reading Hospital, Reading, PA 19611, USAFollow

Document Type

Article

Publication Date

8-2-2022

Abstract

INTRODUCTION: The proliferation of literature regarding the COVID-19 pandemic has served to highlight a wide spectrum of disease manifestations and complications, such as thrombotic microangiopathies. Our review with a brief case presentation highlights the increasing recognition of TTP in COVID-19 and describes its salient characteristics.

METHODS: We screened the available literature in PubMed, EMBASE, and Cochrane databases from inception until April 2022 of articles mentioning COVID-19-associated TTP in English language.

RESULTS: From 404 records, we included 8 articles mentioning data of 11 patients in our review. TTP was predominantly reported in females (72%) with a mean age of 48.2 years (SD 15.1). Dyspnea was the most common symptom in one third of patients (36.6%). Neurological symptoms were reported in 27.3% of cases. The time to diagnosis of TTP was 10 days (SD 5.8) from onset of COVID-19. All 11 cases underwent plasma exchange (PLEX), with a mean of 12 sessions per patient, whereas 6 cases received Rituximab (54.5%), and 3 received Caplacizumab (27.3%). One patient died from the illness.

CONCLUSION: This review of available literature highlights the atypical and refractory nature of COVID-19-associated TTP. It required longer sessions of PLEX, with half of the patients receiving at least one immunosuppressant.

Publication Title

Hematol Rep

Volume

14

Issue

3

First Page

253

Last Page

260

Recommended Citation

Chaudhary, H., Nasir, U., Syed, K., Labra, M., Reggio, C., Aziz, A., Shah, P., Reddy, R., & Sangha, N. (2022). COVID-19-Associated Thrombotic Thrombocytopenic Purpura: A Case Report and Systematic Review.. Hematol Rep, 14 (3), 253-260. https://doi.org/https://doi.org/10.3390/hematolrep14030035