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Auto Immune Thrombocytopenia & Covid 19

Hi, I have auto immune thrombocytopenia and hypothyroidism. I know these do not put me at high risk of catching COVID 19 but I am a little concerned as my immune system is awful. I am always ill with stomach bugs, infections and viruses. Whenever I get ill my platelets drop - I either have blood rashes on legs and feet or bruising and nosebleeds. I have read from scientific studies that:
Platelet count can discriminate between severe and non-severe COVID-19 infections.
Patients who did not survive have a significantly lower platelet count than survivors.
Thrombocytopenia is associated with increased risk of severe disease.
A substantial decrease in platelet count may be an indicator of worsening illness.
Has anyone received a letter to shield from their doctors? Although we are not high risk the evidence Cleary states that COVID 19 is dangerous when you Thrombocytopenia
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1081992 tn?1389903637
COMMUNITY LEADER
Hi, all of that is not saying that having low platelets results in worse CoViD. It is only saying that there is an association. This is useful to ICU docs, because they can use the platelet count as a quickly obtainable marker for how bad a patient is.

In fact, it is probable that the causation goes the other way: that being severe can result in lower platelets, because severe patients can start systemwide coagulation and the platelets get used up that way.  


Whatever immunosuppressive drugs you are taking is a factor. Have you looked at the bottom of the following page for guidance from the British rheumatologists?
https://www.itpsupport.org.uk/index.php/en/news/coronavirus-covid-19-news/171-coronavirus-covid-19-updated-information-statement-from-the-itp-forum-itp-support-association-23rd-march-2020

-------begin quoting-------

...a summary of that advice as it relates to typical ITP treatment is written below.

Consider you have a significant increased risk of infection (extremely vulnerable from COVID-19) if taking:

    Corticosteroids ≥20mg (0,5mg/kg) prednisolone (or equivalent per day for more than 4 weeks
    Corticosteroid dose of ≥5mg prednisolone (or equivalent) per day for more than four weeks plus at least one other immunosuppressive medication (e.g. azathioprine, mycophenolate, ciclosporin) or rituximab within the last 12 months.
    A combination of 2 immunosuppresive medications including rituximab within the last 12 months plus an additional co-morbidity (age >70, Diabetes Mellitus, any pre-existing lung disease, renal impairment, any history of Ischaemic Heart Disease or hypertension)

Most patients with controlled disease and no major co-morbidities receiving a single immunosuppressive therapy would be considered to have moderate risk and take standard advice on social distancing and staying at home.  However some individuals on a single immunosuppressive therapy may have other concerns or high-risk circumstances and following individual risk assessment be advised to follow guidelines for the extremely vulnerable.
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
"my immune system is awful. I am always ill with stomach bugs, infections and viruses"
If it were me, I'd personally take that very seriously and practice extra caution.
Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
Here is more guidance, from the big Hematologists' group, updated April 8, 2020.
https://www.hematology.org/covid-19/covid-19-and-itp

Feel free with any questions.
Helpful - 0
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