{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T19:49:48Z","timestamp":1776541788231,"version":"3.51.2"},"reference-count":20,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Heparin-induced thrombocytopenia (HIT) has not been included as a possible cause of thrombocytopenia in Coronavirus Disease 2019 (COVID-19) patients. We report a case of HIT in a patient with COVID-19 treated with heparin. A 78-year-old man was admitted to our hospital for acute respiratory failure and acute renal failure due to SARS-CoV-2 infection; in intensive care unit, one 5000 IU heparin dose (day 0, platelet count 305,000\/\u03bcL). On day 2, haemoglobin started to decrease and heparin was stopped. On day 10, platelet count was 153,000\/\u03bcL and 5000 IU calcium heparin subcutaneously twice daily was started. The platelet further decreased, reaching 49,000\/\u03bcL on day 17, and the patient was investigated for suspected HIT: an IgG specific chemiluminescence test for heparin-PF4 antibodies was positive and a femoral DVT was found at ultrasound. Argatroban was started, platelet count increased without any bleeding and thrombosis complication. Our experience shows that HIT may develop in heparin treated COVID-19 patients and should be included among the possible cause of thrombocytopenia in such patients.<\/jats:p>","DOI":"10.4081\/hr.2021.8857","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T08:50:20Z","timestamp":1615539020000},"page":"8857","source":"Crossref","is-referenced-by-count":15,"title":["Heparin-Induced Thrombocytopenia and COVID-19"],"prefix":"10.3390","volume":"13","author":[{"given":"Michelangelo","family":"Sartori","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benilde","family":"Cosmi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s11239-020-02134-3","article-title":"COVID-19 update: Covid- 19-associated coagulopathy","volume":"50","author":"Becker","year":"2020","journal-title":"J Thromb Thrombolysis"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.thromres.2020.04.041","article-title":"Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis","volume":"191","author":"Klok","year":"2020","journal-title":"Thromb Res"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.thromres.2020.04.024","article-title":"Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy","volume":"191","author":"Lodigiani","year":"2020","journal-title":"Thromb Res"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.jacc.2020.05.053","article-title":"High prevalence of deep vein thrombosis in mechanically ventilated COVID-19 patients [published online ahead of print, 2020 May 29]","volume":"76","author":"Voicu","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jacc.2020.05.001","article-title":"Association of Treatment Dose Anticoagulation With In-Hospital Survival Among Hospitalized Patients With COVID-19","volume":"76","author":"Paranjpe","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/s11239-020-02162-z","article-title":"The association between treatment with heparin and survival in patients with Covid-19","volume":"50","author":"Ayerbe","year":"2020","journal-title":"J Thromb Thrombolysis"},{"key":"ref7","first-page":"1","article-title":"Venous Thromboembolism Complicated with COVID-19: What Do We Know So Far? [published online ahead of print, 2020 May 12]","author":"Tal","year":"2020","journal-title":"Acta Haematol"},{"key":"ref8","first-page":"167","article-title":"COVID-19 and haemostasis: a position paper from Italian Society on Thrombosis and Haemostasis (SISET)","volume":"18","author":"Marietta","year":"2020","journal-title":"Blood Transfus"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1586\/17474086.2015.1087845","article-title":"Current management of heparin-induced thrombocytopenia","volume":"8","author":"Cosmi","year":"2015","journal-title":"Expert Rev Hematol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"3691","DOI":"10.1182\/blood.V84.11.3691.bloodjournal84113691","article-title":"Sera from patients with heparininduced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin induced thrombocytopenia","volume":"84","author":"Warkentin","year":"1994","journal-title":"Blood"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1111\/bjh.16817","article-title":"The association between severe COVID-19 and low platelet count: evidence from 31 observational studies involving 7613 participants","volume":"190","author":"Jiang","year":"2020","journal-title":"Br J Haematol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1111\/j.1538-7836.2006.01787.x","article-title":"Evaluation of pretest clinical score (4 T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings","volume":"4","author":"Lo","year":"2006","journal-title":"J Thromb Haemost"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"e495S","DOI":"10.1378\/chest.11-2303","article-title":"Treatment and prevention of heparininduced thrombocytopenia: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence- Based Clinical Practice Guidelines","volume":"141","author":"Linkins","year":"2012","journal-title":"Chest"},{"key":"ref14","first-page":"328","article-title":"Detection of anti-heparin-PF4 complex antibodies in COVID-19 patients on heparin therapy","volume":"18","author":"Dragonetti","year":"2020","journal-title":"Blood Transfus"},{"key":"ref15","first-page":"2324709620944091","article-title":"Heparin-Induced Thrombo - cytopenia in COVID-19","volume":"8","author":"Lingamaneni","year":"2020","journal-title":"J Investig Med High Impact Case Rep"},{"key":"ref16","doi-asserted-by":"crossref","DOI":"10.1002\/ajh.25935","article-title":"Heparin induced thrombocytopenia antibodies in Covid-19","author":"Patell","year":"2020","journal-title":"Am J Hematol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/bjh.14482","article-title":"How do we approach thrombocytopenia in critically ill patients?","volume":"177","author":"Thachil","year":"2017","journal-title":"Br J Haematol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.thromres.2020.06.008","article-title":"Mechanisms involved in the development of thrombocytopenia in patients with COVID-19","volume":"193","author":"Zhang","year":"2020","journal-title":"Thromb Res"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.ejim.2020.05.011","article-title":"Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy","volume":"76","author":"Morena","year":"2020","journal-title":"Eur J Intern Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1182\/blood-2018-04-847483","article-title":"High sensitivity and specificity of an automated IgG-specific chemilumi - nescence immunoassay for diagnosis of HIT","volume":"132","author":"Warkentin","year":"2018","journal-title":"Blood"}],"container-title":["Hematology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.pagepress.org\/journals\/index.php\/hr\/article\/download\/8857\/8537","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mdpi.com\/2038-8330\/13\/1\/8857\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T07:35:54Z","timestamp":1645601754000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2038-8330\/13\/1\/8857"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,12]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["hr.2021.8857"],"URL":"https:\/\/doi.org\/10.4081\/hr.2021.8857","relation":{},"ISSN":["2038-8330"],"issn-type":[{"value":"2038-8330","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,12]]}}}