My COVID recovered uncle's platelet count is reducing even with apheresis. Why?

Question

Hi doctor,

My uncle got cured of COVID recently. There was a drop in platelets during his recovery, and apheresis was performed on him, by which the platelet count increased from 3000 to 51000 in four days. But now again it dropped to 12000. Can I know the reason? How much time will it take to cure? Kindly guide me.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your query, and I understand your concern. As mentioned in the query, following the COVID-19 pandemic, there has been a decline in platelet count.

The reason for this could be:

1) ITP (idiopathic thrombocytopenic purpura) is due to immune-mediated destruction of the platelet. It can get precipitated after a viral infection. Need treatment with steroids or IVIg (intravenous immunoglobulin).

2) Drug-induced: Many drugs on their own can cause low platelets. Can recover after stopping the offending drug.

3) Heparin-induced thrombocytopenia (HIT) develops as a reaction to heparin, commonly used in the treatment of COVID. Needs to be managed with a change in anticoagulant.

In your uncle's case, I would need more information, such as his platelet count before contracting COVID. Are there any signs of bleeding? What medications is he taking? What are his other blood reports?

Meanwhile, his platelet count should be above 15,000. And if there is any bleeding, it should be kept above 30000 at least, as there is a risk of bleeding in internal organs, which can be dangerous. Please answer the questions so that I can guide you accordingly.