Introduction

Thrombotic microangiopathies are a group of disorders that are mainly related to endothelial dysfunction. This category of endothelial dysfunction results of several imbalances between platelets, endothelium and immune system, also cytokine production.

Aim of this study

To report cases with thrombotic thrombocytopenic purpura (TTP) and COVID-19 and review COVID-19 endothelial dysfunction literature.

Methods

Primary laboratory data, peripheral blood smear, ADAMTS13 antigen activity level, and antibody ordered for each of these four patients. Treatments for COVID-19 administered for all patients. Traditional treatments for TTP also were administered.

Results

There were numerous schistocytes (more than 5%) in peripheral blood smears for each patient. ADAMTS13 antigen activity level was below 10%, and ADAMTS13 antibody was elevated for each patient. COVID-19 PCR was positive for all patients, and CT-Scans were indicative of the involvement of COVID-19.

Conclusion

In this case series, we reported four COVID-19 patients who presented with signs and symptoms of anemia and thrombocytopenia, resulting in thrombotic thrombocytopenic purpura.

中文翻译：

---

COVID-19相关的血栓性血小板减少性紫癜（TTP）；案例系列和迷你评论

介绍

血栓性微血管病是一组主要与内皮功能障碍相关的疾病。这类内皮功能障碍是血小板、内皮和免疫系统之间以及细胞因子产生之间的多种不平衡的结果。

本研究的目的

报告血栓性血小板减少性紫癜 (TTP) 和 COVID-19 病例并回顾 COVID-19 内皮功能障碍文献。

方法

这四位患者的主要实验室数据、外周血涂片、ADAMTS13 抗原活性水平以及订购的抗体。对所有患者进行 COVID-19 治疗。还进行了 TTP 的传统治疗。

结果

每位患者外周血涂片均可见大量片状红细胞（超过5%）。每个患者的 ADAMTS13 抗原活性水平低于 10%，且 ADAMTS13 抗体升高。所有患者的 COVID-19 PCR 呈阳性，CT 扫描表明有 COVID-19 的参与。

结论

在本病例系列中，我们报告了四名出现贫血和血小板减少症体征和症状的 COVID-19 患者，导致血栓性血小板减少性紫癜。