Chaudhary Haseeb, Nasir Usama, Syed Khezar, Labra Maria, Reggio Christopher, Aziz Ansar, Shah Parin, Reddy Roopika, Sangha Navdeep
Department of Internal Medicine, Reading Hospital, Reading, PA 19611, USA.
Department of Hospital Medicine, Reading Hospital, Reading, PA 19611, USA.
Hematol Rep. 2022 Aug 2;14(3):253-260. doi: 10.3390/hematolrep14030035.
The proliferation of literature regarding the COVID-19 pandemic has served to highlight a wide spectrum of disease manifestations and complications, such as thrombotic microangiopathies. Our review with a brief case presentation highlights the increasing recognition of TTP in COVID-19 and describes its salient characteristics.
We screened the available literature in PubMed, EMBASE, and Cochrane databases from inception until April 2022 of articles mentioning COVID-19-associated TTP in English language.
From 404 records, we included 8 articles mentioning data of 11 patients in our review. TTP was predominantly reported in females (72%) with a mean age of 48.2 years (SD 15.1). Dyspnea was the most common symptom in one third of patients (36.6%). Neurological symptoms were reported in 27.3% of cases. The time to diagnosis of TTP was 10 days (SD 5.8) from onset of COVID-19. All 11 cases underwent plasma exchange (PLEX), with a mean of 12 sessions per patient, whereas 6 cases received Rituximab (54.5%), and 3 received Caplacizumab (27.3%). One patient died from the illness.
This review of available literature highlights the atypical and refractory nature of COVID-19-associated TTP. It required longer sessions of PLEX, with half of the patients receiving at least one immunosuppressant.
关于新冠疫情的文献大量涌现，突显了广泛的疾病表现和并发症，如血栓性微血管病。我们结合一个简短的病例报告进行的综述，突出了新冠病毒感染相关血栓性血小板减少性紫癜（TTP）越来越受到关注，并描述了其显著特征。
我们检索了PubMed、EMBASE和Cochrane数据库中从建库至2022年4月期间以英文提及新冠病毒感染相关TTP的文章。
从404条记录中，我们纳入了8篇文章，其中提及了11例患者的数据。TTP主要见于女性（72%），平均年龄48.2岁（标准差15.1）。三分之一的患者（36.6%）最常见的症状是呼吸困难。27.3%的病例报告有神经系统症状。从新冠病毒感染发病到诊断TTP的时间为10天（标准差5.8）。所有11例患者均接受了血浆置换（PLEX），每位患者平均置换12次，6例患者接受了利妥昔单抗治疗（54.5%），3例接受了卡泊单抗治疗（27.3%）。1例患者因病死亡。
对现有文献的综述突出了新冠病毒感染相关TTP的非典型性和难治性。它需要更长疗程的血浆置换，半数患者至少接受一种免疫抑制剂治疗。
