Continuous thrombocytopenia after SARS-CoV-2 nucleic acid negative in a non-severe COVID-19 patient for several months
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CASE REPORT
Open Access
Continuous thrombocytopenia after SARSCoV-2 nucleic acid negative in a non-severe COVID-19 patient for several months Xia Wu1, Dongxia Luo2, Yaling Liu2, Yilan Zeng2*† and Yuping Gong1*†
Abstract Background: Thrombocytopenia was common in the coronavirus disease (Covid-19) patients during the infection, especially in severe COVID-19 patients, but was less in the non-severe Covid-19 patients. However, the platelet count would be restored after antivirus treatment. In this paper, we report continuous thrombocytopenia in a nonsevere Covid-19 case after a negative nucleic acid test for Covid-19. Case presentation: A non-severe COVID-19 patient had the platelet continuous decrease for several months after the SARS-CoV-2 nucleic acid turning negative, and without well response to the glucocorticoid. The dynamic change of platelet count followed that of the lymphocyte count. After excluding the medicines possibility, immune system disorders, other specific virus infection and specific antibody of platelet, the thrombocytopenia continuously lasted for several months. The upward trend did not begin until June 2020 and she took the tapering dose of prednisone under the instruction of the hematologist. Conclusion: Excluding other potentialities inducing thrombocytopenia, we highly hypothesized the SARS-CoV-2 may cause thrombocytopenia by disturbing the immune system to induce the thrombocytopenia in our report,, which needs longer time to restore the immune system and platelet count via the glucocorticoid. We firstly reported this case in order to contribute the clinician to better deal with the patients like this. Keywords: Non-severe COVID-19, Continuous thrombocytopenia, SARS-CoV-2
Background In December 2019, a cluster of unknown acute respiratory illness occurred in Wuhan, the capital city of Hubei province in China. Now the disease known as coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has since been declared a pandemic by the Word Health Organization on March 11, 2020 [1]. Fever, dry cough, fatigue, anorexia and dyspnea are common symptoms in patients with * Correspondence: [email protected]; [email protected] † Yilan Zeng and Yuping Gong contributed equally to this work. 2 Department of Internal Medicine, The Public and Health Clinic Centre of Chengdu, Chengdu, China 1 Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
COVID-19, and the human-to-human transmission of COVID-19 has been confirmed [2]. Like SARS-CoV and MERS-CoV, SARS-CoV-2 has also been reported to induce thrombocytopenia, especially in severe COVID-19 [3–8], but the platelet count is restored after timely antivirus treatment. However, there is no report about significant reduction of platelets in non-severe COVID-19 patients following SARS-CoV-2 nucleic acid turning negative. Here, we report our first non-severe Covid-19 case of continuous thrombocytopenia after a negative nucleic acid test for Covid-19. We hypot
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