Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

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

Version 1 : Received: 29 June 2022 / Approved: 30 June 2022 / Online: 30 June 2022 (09:06:54 CEST)

A peer-reviewed article of this Preprint also exists.

Chaudhary, H.; Nasir, U.; Syed, K.; Labra, M.; Reggio, C.; Aziz, A.; Shah, P.; Reddy, R.; Sangha, N. COVID-19-Associated Thrombotic Thrombocytopenic Purpura: A Case Report and Systematic Review. Hematol. Rep. 2022, 14, 253-260. Chaudhary, H.; Nasir, U.; Syed, K.; Labra, M.; Reggio, C.; Aziz, A.; Shah, P.; Reddy, R.; Sangha, N. COVID-19-Associated Thrombotic Thrombocytopenic Purpura: A Case Report and Systematic Review. Hematol. Rep. 2022, 14, 253-260.

Abstract

Introduction: The proliferation of literature regarding COVID-19 pandemic has served to highlight a wide spectrum of disease manifestations and complications like 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 database from inception till 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 1/3rd 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 six cases received Rituximab (54.5%), and three 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.

Keywords

SARS-COV-2; COVID-19; TTP; refractory; thrombotic microangiopathies

Subject

Medicine and Pharmacology, Hematology

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