# The Effect of COVID‐19 on Platelet Counts in Persistent and Chronic Adult ITP Patients: A Real‐World Study in China

## TL;DR

This study examines how mild COVID-19 affects platelet levels in adult ITP patients, finding temporary increases in platelet counts among those treated with TPO-RA drugs.

## Contribution

The study reveals that TPO-RA-treated ITP patients experience transient platelet surges after mild COVID-19, suggesting a synergistic effect with inflammatory cytokines.

## Key findings

- TPO-RA-treated ITP patients showed transient platelet surges peaking one week post-infection.
- Platelet levels returned to baseline within 2–3 weeks after infection.
- The platelet response in ITP patients contrasts with thrombocytopenia patterns in non-ITP populations.

## Abstract

While coronavirus disease 2019 (COVID‐19)‐associated thrombocytopenia is well‐documented, its effects on immune thrombocytopenia (ITP) patients remain unclear. This study aimed to investigate the impact of COVID‐19 infection on platelet (PLT) dynamics in chronic ITP patients.

This retrospective study analyzed 21 persistent and chronic ITP patients before and after mild COVID‐19 infection during China's December 2022 reopening, comparing platelet parameter changes with a focus on clinical characteristics of thrombopoietin receptor agonist (TPO‐RA) treated patients.

TPO‐RA treated patients demonstrated transient platelet surges peaking at 1 week postinfection, returning to baseline within 2–3 weeks, contrasting sharply with thrombocytopenia patterns in non‐ITP populations. This suggests synergistic effects between virus‐induced inflammatory cytokines and TPO‐RA may drive transient megakaryopoiesis.

These findings underscore infection‐related PLT fluctuations in ITP, necessitating monitoring for thrombotic and bleeding risks and TPO‐RA dose optimization during infections.

The authors have confirmed clinical trial registration is not needed for this submission