Comparison of HIT Tests in Patients with COVID-19 and Thrombocytopenia

Abstract

Thrombosis and coagulopathy have been found to be the most prevalent complications in patients with COVID-19. Thromboprophylaxis to prevent thromboembolic events is recommended for hospitalized COVID-19 patients. Heparin-induced thrombocytopenia (HIT) is a known complication of heparin use. This study aimed to determine the incidence of HIT among admitted patients with confirmed COVID-19 by PCR. In this study, two different HIT assays, rapid immunoassay (STic Expert HIT, Stago) and H-PF4 specific enzyme-linked immunosorbent assay (Asserachrom^® HPIA – IgG), were performed. Of 200 patients with confirmed COVID-19, we identified 49 patients who met the possibility of HIT (low platelet count and high D-Dimer level). Only five (10.2%) had a positive HIT rapid test. However, none of the tested samples tested positive by ELISA. Thrombosis was reported in two of five (40%) patients. Further extensive studies are required to determine the prevalence and clinical significance of a positive HIT test among patients with COVID-19.

Keywords:

• COVID-19
• thrombosis
• coagulopathy

Abbreviations

HIT, heparin-induced thrombocytopenia; VTE, venous thromboembolism; PF4, platelet factor 4; IgG, immunoglobulin G; FcRIIA, F cellular human immunoglobulin receptor IIa; ARDS, acute respiratory distress syndrome; OD, optical density; PA, polyanion.

Data Sharing Statement

Data are available upon request to the corresponding author.

Ethics Approval and Informed Consent

This study was approved by the Ethics Committee of King Faisal Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia. Informed consent was obtained from the study participants prior to the commencement of the study. This study was conducted in accordance with the Declaration of Helsinki.

Acknowledgments

The authors acknowledge Stago Diagnostic Company for support and providing some of the reagents.

Disclosure

The authors report no conflict of interest in this work.

Additional information

Funding

We had received some of the reagents as a donation from Stago Diagnostic Company.