新型冠状病毒肺炎对持续性及慢性成人免疫性血小板减少症患者血小板计数的影响：一项中国的真实世界研究
The Effect of COVID-19 on Platelet Counts in Persistent and Chronic Adult ITP Patients: A Real-World Study in China.
作者信息
Zhang Yujiao, Yang Lei, Xu Zhongping, Zhou Xin
机构信息
Department of Hematology The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University Wuxi Jiangsu China.
Department of Critical Care Medicine The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University Wuxi Jiangsu China.
出版信息
EJHaem. 2025 Mar 29;6(2):e70025. doi: 10.1002/jha2.70025. eCollection 2025 Apr.
OBJECTIVE
While coronavirus disease 2019 (COVID-19)-associated thrombocytopenia is well-documented, its effects on immune thrombocytopenia (ITP) patients remain unclear. This study aimed to investigate the impact of COVID-19 infection on platelet (PLT) dynamics in chronic ITP patients.
METHODS
This retrospective study analyzed 21 persistent and chronic ITP patients before and after mild COVID-19 infection during China's December 2022 reopening, comparing platelet parameter changes with a focus on clinical characteristics of thrombopoietin receptor agonist (TPO-RA) treated patients.
RESULTS
TPO-RA treated patients demonstrated transient platelet surges peaking at 1 week postinfection, returning to baseline within 2-3 weeks, contrasting sharply with thrombocytopenia patterns in non-ITP populations. This suggests synergistic effects between virus-induced inflammatory cytokines and TPO-RA may drive transient megakaryopoiesis.
CONCLUSION
These findings underscore infection-related PLT fluctuations in ITP, necessitating monitoring for thrombotic and bleeding risks and TPO-RA dose optimization during infections.
TRIAL REGISTRATION
The authors have confirmed clinical trial registration is not needed for this submission.
目的
虽然2019冠状病毒病（COVID-19）相关的血小板减少症已有充分记录，但其对免疫性血小板减少症（ITP）患者的影响仍不清楚。本研究旨在调查COVID-19感染对慢性ITP患者血小板（PLT）动态变化的影响。
方法
这项回顾性研究分析了2022年12月中国重新开放期间21例轻度COVID-19感染前后的持续性和慢性ITP患者，比较血小板参数变化，重点关注血小板生成素受体激动剂（TPO-RA）治疗患者的临床特征。
结果
接受TPO-RA治疗的患者在感染后1周出现短暂的血小板激增，峰值出现在感染后1周，在2-3周内恢复到基线水平，这与非ITP人群的血小板减少模式形成鲜明对比。这表明病毒诱导的炎性细胞因子与TPO-RA之间的协同作用可能驱动短暂的巨核细胞生成。
结论
这些发现强调了ITP中与感染相关的血小板波动，在感染期间需要监测血栓形成和出血风险以及优化TPO-RA剂量。
试验注册
作者已确认本提交内容无需临床试验注册。
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