{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:51:42Z","timestamp":1791345102402,"version":"4.3.1"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Immune thrombocytopenia (ITP) is a recognized hematologic complication associated with coronavirus disease 2019 (COVID\u201019), but its persistence years after acute infection remains uncommon. We present a case of a 52\u2010year\u2010old male who was diagnosed with COVID\u201019 in June 2020. Following recovery from the acute illness, he had persistent fatigue, reduced energy levels, and poor appetite. Laboratory testing at his first follow\u2010up revealed thrombocytopenia with a platelet count of 60,000\/mm\n                    <jats:sup>3<\/jats:sup>\n                    . He had no bleeding manifestations or organomegaly. A trial of oral corticosteroids in a tapering dose produced a partial response, with the platelet count rising to 94,000\/mm\n                    <jats:sup>3<\/jats:sup>\n                    . Subsequently, a bone marrow biopsy was performed, confirming the diagnosis of ITP, excluding infiltration and dysplasia. Over the following 5 years, the patient continued to demonstrate persistent thrombocytopenia requiring a close clinical monitoring and follow\u2010up. This case highlights persistent ITP as a long\u2010term sequela of COVID\u201019, extending more than 4 years after the initial infection. It underscores the importance of considering post\u2010COVID hematologic complications in patients presenting with chronic thrombocytopenia and emphasizes the need for ongoing surveillance and individualized management strategies.\n                  <\/jats:p>","DOI":"10.1002\/puh2.70412","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:24:26Z","timestamp":1791343466000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Immune Thrombocytopenia as a Post\u2010Acute Sequelae of COVID\u201019: A Case Report"],"prefix":"10.1002","volume":"5","author":[{"family":"Riazullah","sequence":"first","affiliation":[{"name":"Department of Medicine Medical Teaching Institute\u2014Mardan Medical Complex  Mardan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4653-3803","authenticated-orcid":false,"given":"Hakim Ullah","family":"Wazir","sequence":"additional","affiliation":[{"name":"Department of Medicine Medical Teaching Institute\u2014Lady Reading Hospital  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7037-2238","authenticated-orcid":false,"given":"Aafeen","family":"Mujeeb","sequence":"additional","affiliation":[{"name":"Department of Medicine Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0423-4790","authenticated-orcid":false,"given":"Hamid","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Medicine Medical Teaching Institute\u2014Mardan Medical Complex  Mardan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2259-3596","authenticated-orcid":false,"given":"Hameed Ur","family":"Rehman","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine Sligo University Hospital  Sligo Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8275-5713","authenticated-orcid":false,"given":"Inibehe Ime","family":"Okon","sequence":"additional","affiliation":[{"name":"Department of Research Medical Research Circle (MedReC)  Bukavu Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102010\u201008\u2010302984"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2010472"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185\u2010020\u201002943\u20105"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0955\u20103886(98)00036\u20108"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1055\/s-0039-1683416","article-title":"Epidemiology and Clinical Manifestations of Immune Thrombocytopenia","volume":"39","author":"Kohli R.","year":"2019","journal-title":"Hamostaseologie"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010023\u201001401\u2010z"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/sci\u20102020\u2010060"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201001\u2010129155"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm6020016"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000036936"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2021.032"}],"container-title":["Public Health Challenges"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70412","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/puh2.70412","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:24:29Z","timestamp":1791343469000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/puh2.70412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["10.1002\/puh2.70412"],"URL":"https:\/\/doi.org\/10.1002\/puh2.70412","archive":["Portico"],"relation":{},"ISSN":["2769-2450","2769-2450"],"issn-type":[{"value":"2769-2450","type":"print"},{"value":"2769-2450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2025-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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