COVID-19 Hematologic Complications

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Complications

Thrombocytopenia

There is an association between severe COVID-19 infection and thrombocytopenia. (lippi) Thrombocytopenia is seen in 57.7% of patients with severe COVID-19 infection compared to 31.6 % of patients with non-severe infection. (GUAN)

The pathogenesis of thrombocytopenia in COVID-19 infection is due to several factors: (XU et al)

1.    Decrease in primary platelet production due to:
   • Infection of bone marrow cells by coronaviruses(12-yang) and inhibition  of bone marrow growth, (14 yeager) which lead to abnormal  hematopoietic function
   • Cytokine storm caused by COVID-19 infection results in the destruction of bone marrow progenitor cells (XU)
2.    Increase in platelet destruction due to increase in autoantibodies and immune complexes (18-nardi/XU)
3.    Decrease in circulating platelet due to lung injury which causes
   • Activation of platelets that result in platelet aggregation and formation of microthrombus  which lead to increase in platelet consumption XU)
   • Decrease in pulmonary capillary bed and megakaryocyte fragmentation result in decrease in platelet production(17lefransias, XU)