Delayed‐phase thrombocytopenia in patients with coronavirus disease 2019 (COVID‐19)

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Abstract

Coronavirus disease 2019 (COVID‐19) can affect the haematopoietic system. Thrombocytopenia at admission was prevalent, while late‐phase or delayed‐phase thrombocytopenia (occurred 14 days after symptom onset) is rare. This retrospective, single‐centre study screened 450 COVID‐19 patients and enrolled 271 patients at the Union Hospital, Wuhan, China, from January 25 to March 9, 2020. COVID‐19‐associated delayed‐phase thrombocytopenia occurred in 11·8% of enrolling patients. The delayed‐phase thrombocytopenia in COVID‐19 is prone to develop in elderly patients or patients with low lymphocyte count on admission. The delayed‐phase thrombocytopenia is significantly associated with increased length of hospital stay and higher mortality rate. Delayed‐phase nadir platelet counts demonstrated a significantly negative correlation with B cell percentages. We also provided and described bone marrow aspiration pathology of three patients with delayed‐phase thrombocytopenia, showing impaired maturation of megakaryocytes. We speculated that immune‐mediated platelet destruction might account for the delayed‐phase thrombocytopenia in a group of patients. In addition, clinicians need to pay attention to the delayed‐phase thrombocytopenia especially at 3–4 weeks after symptom onset.

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  1. SciScore for 10.1101/2020.04.11.20059170: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was performed in accordance to the principles of the Declaration of Helsinki and was approved by the Research Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (No. 2020-0079-1).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableWe collected data on age, gender, respiratory rate, smoking and comorbidities (Hepatitis B, Hepatitis C, HIV, hepatosplenomegaly, hematological system disease, rheumatic immune system disease, cardio cerebrovascular disease, endocrine system disease, respiratory system disease, digestive system disease, nervous …