COVID-19 associated thrombotic thrombocytopenic purpura: A case report and review of the literature Review


Authors: Bou Sanayeh, E.; Al Mahmasani, L.; Khamis, Z.; Barakat, S.; El Chamieh, C.; Khattar, G.; Matar, A.; Kreidieh, F.; Temraz, S.
Review Title: COVID-19 associated thrombotic thrombocytopenic purpura: A case report and review of the literature
Abstract: Introduction: Thrombotic thrombocytopenic purpura (TTP) is a rare but potentially life-threatening complication whose association with COVID-19 is controversial. Understanding this connection is essential due to its significant impact on patient outcomes, and timely diagnosis and intervention are critical in managing this condition effectively. Areas covered: This paper presents a case of TTP triggered by COVID-19 infection in a 48-year-old female. Additionally, a comprehensive literature review was conducted using PubMed and Google Scholar databases, from inception through August 2024, to identify all published cases of COVID-19-associated TTP. The literature search focused on adult cases of TTP secondary to COVID-19 infection, highlighting the treatments used and patient outcomes. Expert opinion: In this report, we highlight the importance of recognizing TTP as a possible complication of COVID-19. While the standard treatment for TTP–plasma exchange and corticosteroids–remains the primary approach, we note that COVID-19-related cases exhibit a high risk of early relapse, as seen in our patient. The literature review suggests that TTP triggered by COVID-19 may have unique characteristics, such as a persistent low ADAMTS13 activity and increased relapse rates. Larger studies are necessary to develop optimal treatment guidelines and understand whether the presence of COVID-19 alters the typical clinical course of TTP. © 2025 Informa UK Limited, trading as Taylor & Francis Group.
Keywords: thrombocytopenia; thrombotic thrombocytopenic purpura; plasma exchange; covid-19 infection; coagulation cascade
Journal Title: Expert Review of Hematology
ISSN: 1747-4086
Publisher: Taylor & Francis Group  
Publication status: Online ahead of print
Date Published: 2025-02-01
Online Publication Date: 2025-02-01
Language: English
DOI: 10.1080/17474086.2025.2459260
PROVIDER: scopus
PUBMED: 39856588
DOI/URL:
Notes: Review -- Source: Scopus
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