Table 1.
Timeline of laboratory values and treatments
| Hospitalization daya | ITP daya | Hb (g/L) | Plt count (× 109/L) | WBC (× 109/L) | Lymphocytes (× 109/L) | Creatinine (μmol/L) | INR | aPTT (s) | Fibrinogen (g/L) | D-dimers (μg/L) | Max FiO2 (%) | Started treatments (excluding transfusions) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 117 | 244 | 10.2 | 0.1 | 222 | 1.0 | 25 | 5.6 | – | 70 | – | |
| 19 | 76 | 311 | 11.9 | – | 1.0 | 28 | 8.9 | – | 35 | – | ||
| 20 | 1 | 77 | 23 | 13.2 | – | 384 | 1.1 | 29 | 6.7 | – | 100b | IVIG × 2 days + high-dose dexamethasone × 4 days (days 3–6) |
| 24 | 5 | 71 | < 10 | 19.3 | – | 132 | 0.9 | 23 | 6.8 | – | 60 | Romiplostim × 10 days |
| 28 | 9 | 98 | 12 | 34.3 | – | 90 | 0.9 | 24 | 6.7 | – | 40 | Vincristine (1 dose) |
| 29 | 10 | 99 | 19 | 34.1 | – | 80 | 1.1 | 26 | 6.7 | – | 35 | Very high dose of methylprednisolone × 4 days |
| 30 | 11 | 100 | 38 | 18.1 | – | 93 | 1.0 | 26 | 5.1 | – | 35 | – |
| 33 | 14 | 93 | 178 | 17 | 1.56 | 66 | 1.1 | 27 | 4.2 | 29710 | 30 | – |
Normal values: hemoglobin—130–170 g/L, platelets—130–400 × 109/L, white blood cells count—4.0–10.0 × 109/L, lymphocytes count—1.0–4.0 × 109/L, creatinine—53–112 μmol/L, INR—0.8–1.1, aPTT—22–31 s, fibrinogen—2–4.5 g/L, D-dimers— < 600 μg/L (< 500 μg/L to rule out thromboembolic diseases in outpatients)
ITP immune thrombocytopenic purpura, Hb hemoglobin, Plt platelet, WBC white blood cells, INR international normalized ratio, aPTT activated thromboplastin time, IVIG intravenous immune globulin
a“Hospitalization day” refers to number of days since hospital admission and “ITP day” refer to number of days since ITP diagnosis. The patient had COVID-19 related symptoms for 3 days before he was hospitalized
bFiO2 increased from 35 to 100% this day because of endobronchial hemorrhage