Background Acute respiratory and
renal failure MESHD as well as systemic
coagulopathy MESHD are critical aspects of the morbidity and mortality in patients with
COVID-19 MESHD. Heparin Induced
Thrombocytopenia MESHD (
HIT MESHD) occurs when IgG antibodies form against platelet factor 4-Heparin complex, resulting in platelet activation and removal, leading to a prothrombotic state. Studies have shown that only 6% who are investigated serologically for
HIT MESHD actually have the diagnosis.Methods A retrospective analysis was performed on all
COVID-19 MESHD positive patients hospitalized between March and June 2020. Patients with suspicion for
HIT MESHD were tested for
HIT MESHD antibodies with IgG-specific platelet factor 4(
PF4 HGNC)-dependent enzyme immunoassay (EIA). Confirmatory testing with serotonin release assay (
SRA HGNC) and heparin-induced
platelet aggregation MESHD were used in cases with intermediate or low optical density (OD) with EIA positivity (EIA+). Due to
rarity of disease MESHD, a through literature review on
HIT MESHD in
COVID-19 MESHD patients was also analyzed.Results Incidence of EIA + in
COVID-19 MESHD patients was 0.6%, significantly higher than in the general population 0.2% (p < 0.0001). The incidence of
thromboembolic MESHD events in EIA + patients was 87.5%, significantly higher than the rate of 10.90% in all
COVID-19 MESHD patients (p < 0.0001). The mortality rate in EIA + patients was 50%, significantly greater than the mortality rate of 12% in all hospitalized
COVID-19 MESHD patients (p = 0.0011). Serological confirmation of
HIT MESHD diagnosis was 37.5% which is significantly higher than confirmation of
HIT MESHD in non
COVID-19 MESHD patients 6% (p < 0.0001). Of 39
HIT MESHD antibody positive patients in the literature, 23.07% had positive confirmatory testing (6
SRA HGNC, 3 HIPAA) which is significantly higher than 5.6% in the general population (p = 0.00001). The incidence of
thrombosis MESHD in EIA +
COVID-19 MESHD patients in the literature was 56.4% which is significantly higher than reported rates of
thrombotic MESHD events in in all
COVID-19 MESHD patients in the literature at 4.8%1 (p = 0.00001).Conclusion Our study indicates incidence of
HIT MESHD is higher in the
COVID-19 MESHD population. This can be attributed to the cytokine storm and severe
sepsis MESHD seen in critically ill
COVID-19 MESHD patients. Our study also suggests that development of
HIT MESHD can contribute to increased risk for
thromboembolic MESHD events as well as mortality of
COVID-19 MESHD patients, however, our study is limited due to small sample size.