Decreased Platelet Count Due to Heparin in Covid-19

Abstract

COVID-19 (coronavirus disease-2019) infection may be a extremely prothrombotic state, ensuing from a dysregulation of the coagulation cascade. Therefore, thromboprophylaxis is powerfully suggested in these patients, with some consultants even advocating for therapeutic dosing to forestall thromboembolic events. Heparin-induced blood disorder (HIT) may be a well-known complication of heparin therapy. during this article, we tend to report a case of HIT in a patient with COVID-19. A 52-year-old male with history of one week of dry cough and loose stools. He had a positive COVID-19 reverse-transcriptase–polymerase chain reaction. On admission, the platelet count and liver function test were within normal limits. Throughout his hospitalization, he developed a right femoral deep venous thrombosis and was started on therapeutic anticoagulations. Due to worsening respiratory failure, he was intubated and mechanically ventilated. Between days eight and nine of hospitalization, platelet count decreased from 294000 to 89000 cells/μL. He had a high pretest likelihood for HIT with a 4T score of 6 and a positive anti-PF4/ heparin antibody. Heparin drip was interrupted and was switched to Argatroban. The serotinin assay eventually came back positive, that confirmed the diagnosis of HIT.