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An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
In a prospective cohort study conducted between 2 March 2020 and 7 May 2020, a 64-year-old man was described, who developed heparin-induced thrombocytopenia (HIT) during treatment with enoxaparin sodium and heparin.
The man, who was admitted in a hospital due to COVID-19, had been receiving prophylactic treatment with enoxaparin sodium [enoxaparin] 3 000IU twice a day for 5 days and heparin [unfractionated heparin] 20 000IU for 13 days. Platelet count prior to the initiation of heparin was 223 G/L. Subsequently, a decrease in platelet count was observed (nadir: 67 G/L). Further, deep vein thrombosis was also detected. Further investigations revealed 4Ts score of 6, positive particle gel immunoassay (PaGIA) rapid test, positive enzyme-linked immunosorbent assay for HIT-associated IgG antibody, heparin-induced platelet activation index of 74 and positive serotonin release assay. Based on the findings diagnosis of HIT was confirmed [time to reaction onset and outcome not stated]. He also developed cholecystitis complicated by renal failure [aetiology unknown], for which he underwent cholecystectomy.
The boy's prophylactic treatment was changed to argatroban and then to danaparoid sodium [danaparoid] after normalisation of renal function. Subsequently, he was discharged on apixaban.