The complicated relationships of heparin-induced thrombocytopenia and platelet factor 4 antibodies with COVID-19.
Int J Lab Hematol
; 43(4): 547-558, 2021 Aug.
Article
em En
| MEDLINE
| ID: mdl-34000089
ABSTRACT
COVID-19 (coronavirus disease 2019) represents a prothrombotic disorder, and there have been several reports of platelet factor 4/heparin antibodies being present in COVID-19-infected patients. This has thus been identified in some publications as representing a high incidence of heparin-induced thrombocytopenia (HIT), whereas in others, findings have been tempered by general lack of functional reactivity using confirmation assays of serotonin release assay (SRA) or heparin-induced platelet aggregation (HIPA). Moreover, in at least two publications, data are provided suggesting that antibodies can arise in heparin naïve patients or that platelet activation may not be heparin-dependent. From this literature, we would conclude that platelet factor 4/heparin antibodies can be observed in COVID-19-infected patients, and they may occur at higher incidence than in historical non-COVID-19-infected cohorts. However, the situation is complex, since not all platelet factor 4/heparin antibodies may lead to platelet activation, and not all identified antibodies are heparin-dependent, such that they do not necessarily reflect "true" HIT. Most recently, a "HIT-like" syndrome has reported in patients who have been vaccinated against COVID-19. Accordingly, much more is yet to be learnt about the insidious disease that COVID-19 represents, including autoimmune outcomes in affected patients.
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Base de dados:
MEDLINE
Assunto principal:
Trombocitopenia
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Fator Plaquetário 4
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Heparina
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COVID-19
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Anticorpos
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Anticoagulantes
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article