PMID- 34394916
OWN - NLM
STAT- MEDLINE
DCOM- 20210913
LR  - 20230920
IS  - 2046-1402 (Electronic)
IS  - 2046-1402 (Linking)
VI  - 10
DP  - 2021
TI  - Case Report: Heparin-induced thrombocytopenia during COVID-19 outbreak: the 
      importance of scoring system in differentiating with sepsis-induced coagulopathy.
PG  - 469
LID - 10.12688/f1000research.52425.2 [doi]
LID - 469
AB  - Background: COVID-19 disease is accompanied by derangement of coagulation with a 
      risk of fatal thromboembolic formation. COVID-19 patients are among those 
      indicative for heparin treatment. Increased heparin administration among COVID-19 
      patients increased heparin induced-thrombocytopenia's risk with/without 
      thrombocytopenia. Case presentation: We present a 71-year-old male patient who 
      came to the emergency room (ER) with a COVID-19 clinical manifestation followed 
      by positive PCR nasopharyngeal swab result. He was assessed to have acute 
      respiratory distress syndrome (ARDS), as shown by rapid progression of hypoxemic 
      respiratory failure and bilateral pulmonary infiltrate. He was then treated with 
      moxifloxacin, remdesivir, dexamethasone, unfractionated heparin (UFH) pump, and 
      multivitamins. During admission, his respiratory symptoms got worse, so he 
      transferred to the ICU for NIV support. On the ninth day of admission, he had 
      gross hematuria followed by a rapid fall of platelet count. We used two different 
      scoring systems (4Ts and HEP scoring system) to confirm the diagnosis of 
      heparin-induced thrombocytopenia (HIT). Following the discontinuation of UFH 
      injection, the thrombocyte continued to rise, and hematuria disappeared. 
      Conclusion: Heparin-induced thrombocytopenia is associated with an increased risk 
      of severe disease and mortality among COVID-19 patients. The differential 
      diagnosis of HIT could be difficult as thrombocytopenia can also be caused by the 
      progression of infection. We use two scoring systems (4Ts and HEP scoring) in 
      order to help us managing the patient. These could improve the outcomes, thus 
      avoiding morbidity and mortality.
CI  - Copyright: (c) 2021 Wardhani LFK et al.
FAU - Wardhani, Louisa Fadjri Kusuma
AU  - Wardhani LFK
AUID- ORCID: 0000-0001-8955-4373
AD  - Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
AD  - Department of Cardiology and Vascular Medicine, Dr. Soetomo Hospital, Surabaya, 
      Indonesia.
FAU - Dewi, Ivana Purnama
AU  - Dewi IP
AUID- ORCID: 0000-0002-1602-3384
AD  - Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
AD  - Department of Cardiology and Vascular Medicine, Dr. Soetomo Hospital, Surabaya, 
      Indonesia.
AD  - Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia.
FAU - Suwanto, Denny
AU  - Suwanto D
AUID- ORCID: 0000-0002-0224-6712
AD  - Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
AD  - Department of Cardiology and Vascular Medicine, Dr. Soetomo Hospital, Surabaya, 
      Indonesia.
FAU - Ambari, Ade Meidian
AU  - Ambari AM
AD  - University of Indonesia, Jakarta, Indonesia.
FAU - Ardiana, Meity
AU  - Ardiana M
AD  - Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
AD  - Department of Cardiology and Vascular Medicine, Dr. Soetomo Hospital, Surabaya, 
      Indonesia.
AD  - Department of Cardiology and Vascular Medicine, Bhayangkara H.S Samsoeri 
      Mertojoso Hospital, Surabaya, Indonesia.
LA  - eng
PT  - Case Reports
DEP - 20210614
PL  - England
TA  - F1000Res
JT  - F1000Research
JID - 101594320
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/adverse effects
MH  - *COVID-19
MH  - Disease Outbreaks
MH  - Heparin/adverse effects
MH  - Humans
MH  - Male
MH  - SARS-CoV-2
MH  - *Sepsis/diagnosis
MH  - *Thrombocytopenia/chemically induced/diagnosis
PMC - PMC8356265
OTO - NOTNLM
OT  - COVID-19
OT  - HIT
OT  - Heparin Induced Thrombocytopenia
OT  - mortality
COIS- No competing interests were disclosed.
EDAT- 2021/09/10 06:00
MHDA- 2021/09/14 06:00
PMCR- 2021/08/26
CRDT- 2021/09/09 06:51
PHST- 2021/08/11 00:00 [accepted]
PHST- 2021/09/09 06:51 [entrez]
PHST- 2021/09/10 06:00 [pubmed]
PHST- 2021/09/14 06:00 [medline]
PHST- 2021/08/26 00:00 [pmc-release]
AID - 10.12688/f1000research.52425.2 [doi]
PST - epublish
SO  - F1000Res. 2021 Jun 14;10:469. doi: 10.12688/f1000research.52425.2. eCollection 
      2021.