Clinical and laboratory characteristics of hospitalized patients with COVID-19 with negative confirmatory tests for heparin-induced thrombocytopenia
Case . | Age (y), sex . | Severity of COVID-19 . | Indication of heparin . | Type and dose of heparin during HIT diagnosis . | Duration of heparin when tested for HIT (d) . | Initial platelet count (x109 /L) . | Nadir platelet count (x109 /L) . | Thrombosis after heparin initiation . | 4T score . | Screening test . | Confirmatory test . | Non-heparin anticoagulants . | Platelet recovery after HIT treatment . | Patients’ outcomes as reported . |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
126 | 74, M | ICU (MV, ARDS) | DVT prophylaxis | LMWH and UFH; prophylactic | 12 | 143 | 68 | Upper extremity venous thrombosis | 4 | ELISA (OD 1.3) | SRA, negative (0%) | Fondaparinux then bivalirudin | None | Death |
226 | 53, M | ICU (MV, ARDS) | AF | UFH; therapeutic | 11 | 207 | 22 | Skin necrosis | 6 | ELISA (OD 0.48) | SRA negative (0%) | Argatroban then apixaban | Recovery | Alive |
327 | 53, M | ICU (ARDS) | ACS and AF | N/A | 7 | N/A | N/A | None | 5 | ELISA (OD 0.71) | SRA negative | Argatroban | N/A | N/A |
427 | 61. F | ICU (ARDS) | DVT | N/A | 6 | N/A | N/A | DVT | 7 | ELISA (OD 0.77) | SRA, negative | N/A | N/A | N/A |
527 | 68, F | ICU (ARDS) | DVT | N/A | 8 | N/A | N/A | DVT | 7 | ELISA (OD 0.42) | SRA, negative | N/A | N/A | N/A |
627 | 63, M | ICU (ARDS) | Suspected PE | N/A | 2 | N/A | N/A | Suspected PE | 4 | ELISA (OD 0.31) | SRA, negative | N/A | N/A | N/A |
728 | 50, M | ICU (ECMO) | ECMO | UFH; prophylactic | N/A | N/A | 49 | None | 5 | ELISA (OD 0.63) | SRA, negative | N/A | N/A | Death |
828 | 79, F | N/A | VTE prophylaxis | LMWH; prophylactic | N/A | N/A | 155 | None | 3 | ELISA (OD 1.89) | SRA, negative | N/A | N/A | Alive |
928 | 58, F | N/A | VTE prophylaxis | LMWH; prophylactic | N/A | N/A | 305 | PE | 3 | ELISA (OD 0.51) | SRA, negative | N/A | N/A | Death |
1028 | 38, M | ICU (ECMO) | VTE prophylaxis, ECMO | LMWH and UFH; prophylactic | N/A | N/A | 39 | None | 3 | ELISA (OD 0.83) | SRA, negative | N/A | N/A | N/A |
1128 | 71, F | ICU (RRT) | RRT | UFH; prophylactic | N/A | N/A | 70 | Stroke | 6 | ELISA (OD 0.47) | SRA, negative | N/A | N/A | Death |
1228 | 46, M | N/A | VTE prophylaxis | LMWH; prophylactic | N/A | N/A | 59 | DVT | 5 | ELISA (OD 0.83) | SRA, negative | N/A | N/A | N/A |
1329 | 49, M | ICU | COVID pneumonia | UFH; therapeutic | 6 | 211 | 47 | None | 6 | LITA (1.1 U/mL) | SRA, negative | Argatroban | None | Death |
1433 | 77, M | ICU | VTE prophylaxis | LMWH and UFH; prophylactic | 11 | 136 | 59 | None | 5 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1533 | 63, M | ICU | VTE prophylaxis | LMWH and UFH; therapeutic | 14 | 250 | 11 | None | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Alive |
1633 | 60, M | ICU | VTE prophylaxis and DVT treatment | LMWH and UFH; therapeutic | 21 | 153 | 36 | DVT | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1733 | 63, M | ICU | AF | LMWH and UFH; therapeutic | 12 | 177 | 38 | None | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1833 | 71, M | ICU | AF | LMWH and UFH; therapeutic | 21 | 240 | 77 | None | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1933 | 66, M | ICU | PE | UFH; therapeutic | 2 | 121 | 59 | PE and DVT | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Alive |
2033 | 50, M | ICU | VTE prophylaxis | LMWH; prophylactic | 12 | 227 | 136 | Stroke | 6 | PaGIA negative | HIPLA, negative | None | N/A | Alive |
2133 | 67, M | ICU | AF | UFH; therapeutic | 23 | 363 | 138 | DVT | 6 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
2233 | 65, M | ICU | PE suspicion | LMWH and UFH; therapeutic | 24 | 317 | 138 | PE and DVT | 6 | PaGIA, negative | HIPLA, negative | Argatroban | N/A | Death |
2337 | 58, M | N/A | N/A | LMWH; N/A | N/A | N/A | 60 | DVT | ≥4 | ELISA IgG (OD 1.68) | SRA, negative | Argatroban | N/A | Death |
2437 | 77, M | ICU (RRT) | N/A | LMWH and UFH; N/A | N/A | N/A | 28 | Stroke | ≥4 | ELISA IgG (0.7) | SRA, negative | Argatroban | N/A | Alive |
2537 | 36, M | N/A | N/A | LMWH; N/A | N/A | N/A | 2 | None | ≥4 | ELISA IgG (0.88) | SRA, negative | Argatroban | N/A | Alive |
2637 | 34, M | N/A | N/A | LMWH; N/A | N/A | N/A | 65 | DVT | ≥4 | N/A | SRA, negative | Bivalirudin | N/A | Death |
Case . | Age (y), sex . | Severity of COVID-19 . | Indication of heparin . | Type and dose of heparin during HIT diagnosis . | Duration of heparin when tested for HIT (d) . | Initial platelet count (x109 /L) . | Nadir platelet count (x109 /L) . | Thrombosis after heparin initiation . | 4T score . | Screening test . | Confirmatory test . | Non-heparin anticoagulants . | Platelet recovery after HIT treatment . | Patients’ outcomes as reported . |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
126 | 74, M | ICU (MV, ARDS) | DVT prophylaxis | LMWH and UFH; prophylactic | 12 | 143 | 68 | Upper extremity venous thrombosis | 4 | ELISA (OD 1.3) | SRA, negative (0%) | Fondaparinux then bivalirudin | None | Death |
226 | 53, M | ICU (MV, ARDS) | AF | UFH; therapeutic | 11 | 207 | 22 | Skin necrosis | 6 | ELISA (OD 0.48) | SRA negative (0%) | Argatroban then apixaban | Recovery | Alive |
327 | 53, M | ICU (ARDS) | ACS and AF | N/A | 7 | N/A | N/A | None | 5 | ELISA (OD 0.71) | SRA negative | Argatroban | N/A | N/A |
427 | 61. F | ICU (ARDS) | DVT | N/A | 6 | N/A | N/A | DVT | 7 | ELISA (OD 0.77) | SRA, negative | N/A | N/A | N/A |
527 | 68, F | ICU (ARDS) | DVT | N/A | 8 | N/A | N/A | DVT | 7 | ELISA (OD 0.42) | SRA, negative | N/A | N/A | N/A |
627 | 63, M | ICU (ARDS) | Suspected PE | N/A | 2 | N/A | N/A | Suspected PE | 4 | ELISA (OD 0.31) | SRA, negative | N/A | N/A | N/A |
728 | 50, M | ICU (ECMO) | ECMO | UFH; prophylactic | N/A | N/A | 49 | None | 5 | ELISA (OD 0.63) | SRA, negative | N/A | N/A | Death |
828 | 79, F | N/A | VTE prophylaxis | LMWH; prophylactic | N/A | N/A | 155 | None | 3 | ELISA (OD 1.89) | SRA, negative | N/A | N/A | Alive |
928 | 58, F | N/A | VTE prophylaxis | LMWH; prophylactic | N/A | N/A | 305 | PE | 3 | ELISA (OD 0.51) | SRA, negative | N/A | N/A | Death |
1028 | 38, M | ICU (ECMO) | VTE prophylaxis, ECMO | LMWH and UFH; prophylactic | N/A | N/A | 39 | None | 3 | ELISA (OD 0.83) | SRA, negative | N/A | N/A | N/A |
1128 | 71, F | ICU (RRT) | RRT | UFH; prophylactic | N/A | N/A | 70 | Stroke | 6 | ELISA (OD 0.47) | SRA, negative | N/A | N/A | Death |
1228 | 46, M | N/A | VTE prophylaxis | LMWH; prophylactic | N/A | N/A | 59 | DVT | 5 | ELISA (OD 0.83) | SRA, negative | N/A | N/A | N/A |
1329 | 49, M | ICU | COVID pneumonia | UFH; therapeutic | 6 | 211 | 47 | None | 6 | LITA (1.1 U/mL) | SRA, negative | Argatroban | None | Death |
1433 | 77, M | ICU | VTE prophylaxis | LMWH and UFH; prophylactic | 11 | 136 | 59 | None | 5 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1533 | 63, M | ICU | VTE prophylaxis | LMWH and UFH; therapeutic | 14 | 250 | 11 | None | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Alive |
1633 | 60, M | ICU | VTE prophylaxis and DVT treatment | LMWH and UFH; therapeutic | 21 | 153 | 36 | DVT | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1733 | 63, M | ICU | AF | LMWH and UFH; therapeutic | 12 | 177 | 38 | None | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1833 | 71, M | ICU | AF | LMWH and UFH; therapeutic | 21 | 240 | 77 | None | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
1933 | 66, M | ICU | PE | UFH; therapeutic | 2 | 121 | 59 | PE and DVT | 4 | PaGIA, negative | HIPLA, negative | None | N/A | Alive |
2033 | 50, M | ICU | VTE prophylaxis | LMWH; prophylactic | 12 | 227 | 136 | Stroke | 6 | PaGIA negative | HIPLA, negative | None | N/A | Alive |
2133 | 67, M | ICU | AF | UFH; therapeutic | 23 | 363 | 138 | DVT | 6 | PaGIA, negative | HIPLA, negative | None | N/A | Death |
2233 | 65, M | ICU | PE suspicion | LMWH and UFH; therapeutic | 24 | 317 | 138 | PE and DVT | 6 | PaGIA, negative | HIPLA, negative | Argatroban | N/A | Death |
2337 | 58, M | N/A | N/A | LMWH; N/A | N/A | N/A | 60 | DVT | ≥4 | ELISA IgG (OD 1.68) | SRA, negative | Argatroban | N/A | Death |
2437 | 77, M | ICU (RRT) | N/A | LMWH and UFH; N/A | N/A | N/A | 28 | Stroke | ≥4 | ELISA IgG (0.7) | SRA, negative | Argatroban | N/A | Alive |
2537 | 36, M | N/A | N/A | LMWH; N/A | N/A | N/A | 2 | None | ≥4 | ELISA IgG (0.88) | SRA, negative | Argatroban | N/A | Alive |
2637 | 34, M | N/A | N/A | LMWH; N/A | N/A | N/A | 65 | DVT | ≥4 | N/A | SRA, negative | Bivalirudin | N/A | Death |
ARDS, acute respiratory distress syndrome; CIA, chemiluminescent immunoassay (cutoff < 1 U/mL); DVT, deep vein thrombosis; ECMO, extracorporeal membrane oxygenation; ELISA, enzyme-link immunosorbent assay; F, female; HIPLA, heparin-induced platelet activation assay (positivity threshold 13%); ICU, intensive care unit; LITA, latex immune turbidimetric assay; M, male; MV, mechanical ventilation; N/A, not available; PE, pulmonary embolism; RRT, renal replacement therapy; TE, thromboembolism; VTE, venous thromboembolism.