Severe Thrombocytopenia as a Manifestation of COVID-19 Infection

Clinical manifestations of COVID-19 infection can range from an asymptomatic clinical form to acute respiratory distress depending on the virus gateway, viral load, host immunity, and existing comorbidities. Some patients with COVID-19 infection can present hematological changes depending on the patient’s immune response and the severity of the infection. We present two different manifestations of thrombotic disorders related to COVID-19: one severe form of immune thrombocytopenia in a young woman with no comorbidities and a severe form of thrombocytopenia along with disseminated intravascular coagulation and acute urinary obstructive disease. Interestingly, both patients presented no signs of COVID-19 pneumonia. Failure to diagnose thrombocytopenia rapidly may lead to severe complications. Management with immunosuppressive corticosteroids in high doses should carefully balance the risk of bleeding versus deterioration due to infection.