Treatment of patients with COVID-19-associated immune thrombocytopenia in real clinical practice

Abstract

Aim. Demonstration of three clinical cases of immune thrombocytopenic purpura (ITP) that developed during the pandemic of a novel coronavirus infection (COVID-19) from the personal practice of the authors.Materials and methods. A brief review of the literature on the diagnosis and differential diagnosis of COVID-19-associated ITP is presented. Three clinical observations of this pathology are given.Results. In two situations, thrombocytopenia developed after severe COVID-19-associated pneumonia. In one case, ITP was diagnosed after a viral infection; PCR test for COVID19 was negative. A young patient without comorbidities with severe thrombocytopenia and hemorrhagic syndrome was treated with glucocorticoids and thrombopoietin receptor agonists (TPO-RAs). After achieving remission, glucocorticoids were first discontinued, and then TPO-RAs. In elderly patients with a serious comorbid pathology, glucocorticoids were prescribed for a short time, and remission was achieved with TPO-RAs.Conclusion. The choice of therapy for ITP that developed during the COVID-19 pandemic depends on the clinical situation, the presence or absence of COVID-19 infection, the patient’s somatic status, and the presence of comorbid pathology. TPO-RAs play an important role in the treatment of ITP, including those associated with COVID-19.