Table of ContentsView AllTable of ContentsRiskComplicationsTreatmentsHow to Stay Safe
Table of ContentsView All
View All
Table of Contents
Risk
Complications
Treatments
How to Stay Safe
Research regarding immunethrombocytopenia(ITP) and COVID-19 is ongoing. Currently, ITP does not seem to increase the risk of severe disease or developing COVID-19, but it may be a complication of COVID-19 infection and mRNA vaccination.
ITPis a condition in which the immune system abnormally destroys platelets.Plateletsare the type of cells in the blood that help the blood clot and heal blood vessel walls if they are damaged to prevent bleeding.
In ITP, the immune system destroys platelets, causing their numbers to decrease and increasing the risk of bleeding.
Verywell / Jessica Olah
ITP and COVID-19 Risk
Research available at this time does not show that having a previous history of ITP causes an increased risk of becoming infected with COVID-19. However, as ITP can develop as a result of an immune system reaction, there have been reports of people developing ITP during a COVID-19 infection.
If you’re on any type of treatment for ITP, it should be discussed with your healthcare provider to see if these treatments increase your risk of exposure to COVID-19 and to develop an alternate treatment plan if you’re not comfortable going to their office.
Complications of ITP and COVID-19
Thrombocytopenia can be a common finding in someone infected with COVID-19, even if they don’t have a history of ITP. In some cases, it can be severe and lead to significant, even potentially fatal, bleeding.
ITP After COVID-19 Infection
ITP has also been linked to COVID-19 infection in the weeks following COVID-19 onset. One review found most people developed ITP within two to three weeks after COVID-19 infection and recovered in less than one week.
However, there have been reports of ITP diagnosis occurring as late as five weeks and even up to 125 days after the initial COVID-19 diagnosis.
Risk of Blood Clots
Those infected with COVID-19 carry an increased risk of developingblood clots. Generally, this risk is managed with the use of blood-thinning medications such as heparin or enoxaparin.
However, for people living with ITP who have low platelet counts, the use of blood-thinning medications may need to be avoided. This leads to the potential increased risk of clotting.
ITP After COVID-19 mRNA Vaccination
Although it is rare, adverse events have been reported in which ITP symptoms develop about two weeks after COVID-19 mRNA vaccination. In these rare cases, the response to treatment was good with platelets returning to normal.
Given the rare incidence, COVID-19 vaccines are still recommended for almost everyone because the risk of serious outcomes of COVID-19 far outweighs the risk of ITP possibly associated with highly effective vaccines.
Whether people living with ITP should get the COVID-19 vaccine should be discussed with their healthcare team treating ITP. Historically, there have been cases where platelet counts have decreased following a viral infection or immunization (such as MMR and flu vaccines).However, the benefit of the vaccine likely outweighs the risk of decreased platelets, with the possible exception of those with unstable platelet counts.
Whether people living with ITP should get the COVID-19 vaccine should be discussed with their healthcare team treating ITP. Historically, there have been cases where platelet counts have decreased following a viral infection or immunization (such as MMR and flu vaccines).
However, the benefit of the vaccine likely outweighs the risk of decreased platelets, with the possible exception of those with unstable platelet counts.
Immune Thrombocytopenia Treatments and COVID-19
Treatments for ITP may continue to be the same if someone is also experiencing a COVID-19 infection.
Observation
Some people living with ITP are under routine observation of platelet counts through periodic blood tests. The frequency in which someone requires blood tests is dependent upon each person, but if one’s risk of developing COVID-19 infection is high and their platelet counts have been stable, they may potentially delay routine blood testing.
Home blood testing may also be a possibility for those at higher risk of developing COVID-19 due to other factors. This should be discussed with the healthcare team that is monitoring ITP to see if these options are available.
Symptoms of ITP that should be reported to the healthcare team include:
Immunosupressive Medications
Multiple medications can be given to suppress the immune system of someone living with ITP. Thesemedicationsstop the immune system from destroying platelets which can lead to bleeding. If someone with ITP is on medications and does not have an active COVID-19 infection, stopping these medications is not recommended at this time.
However, there is some increased risk of infection and decreased immune building response after infection or immunization up to six months after getting the infusion. There currently isn’t data available to show that this increases the risk of COVID-19 or worsens the infection if contracted.
Other Medications for Immune Thrombocytopenia
In addition to immunosuppressive medications, there are treatments for ITP that do not have any effect on the immune system. Oral medications can be prescribed to increase bone marrow production of platelets, and it is safe to continue these at home.
Other treatments including immune globulin infusions and a bone marrow-stimulating subcutaneous injection require administration in a hospital or infusion center. The risks of coming to an infusion center can be weighed against stopping these medications or switching to another agent to decrease potential for COVID-19 exposure.
Surgery
Surgical procedures, such assplenectomy, may have initially been postponed at the beginning of the COVID-19 pandemic out of fear of decreased healthcare resources and to decrease the risk of the spread of the outbreak.
A splenectomy is done to decrease platelet destruction. However, as long as it is safe to do, these surgeries are being done again.
If someone withITPhad a splenectomy previously, they may be athigher riskof bacterial infections and should make sure they are up to date on current immunizations to prevent infection and decrease the risk of hospitalization during the pandemic.
It does not appear that those with previous splenectomy are at a higher risk of developing COVID-19.
Preventing the spread of COVID-19 variants continues to remain important. The following recommendations should still be in place, even if vaccinated against the virus:
Summary
Having ITP doesn’t seem to increase the risk of getting COVID-19 or the severity of the infection. However, developing ITP during or after COVID-19 infection has occurred in some people.
The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit ourcoronavirus news page.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lemos J, Poças JF, Castro I, et al.Immune thrombocytopenia purpura associated with covid-19 infection: a challenging diagnosis and management. Cureus. Published online October 21, 2023. doi: 10.7759/cureus.47433
American Society of Hematology.COVID-19 and ITP: frequently asked questions.
National Heart, Lung, and Blood Institute.Immune thrombocytopenia.
Alharbi MG, Alanazi N, Yousef A, et al.COVID-19 associated with immune thrombocytopenia: a systematic review and meta-analysis.Expert Rev Hematol. 2022;15(2):157-166. doi:10.1080/17474086.2022.2029699
Rodeghiero F.Practical recommendations for the management of patients with ITP during the COVID-19 pandemic : recommendation for ITP management during COVID.Mediterr J Hematol Infect Dis. 2021;13(1):e2021032. doi:10.4084/MJHID.2021.032
Akiyama H, Kakiuchi S, Rikitake J, et al.Immune thrombocytopenia associated with Pfizer-BioNTech’s BNT162b2 mRNA COVID-19 vaccine. IDCases. 2021;25:e01245. doi: 10.1016/j.idcr.2021.e01245
Centers for Disease Control and Prevention.COVID-19: how to protect yourself and others.
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