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Practical Recommendations for the Management of Patients with ITP During the COVID-19 Pandemic.
Mediterranean Journal of Hematology and Infectious Diseases ( IF 3.2 ) Pub Date : 2021-05-01 , DOI: 10.4084/mjhid.2021.032
Francesco Rodeghiero

The current COVID-19 pandemic requires revisiting our current approach to major blood disorders, including ITP (Immune Thrombocytopenia), stirring up the production of several disease-specific practical guidelines. This report describes an updated version of consensus-based practical guidelines on the management of ITP, adapted to the Italian health system and social context. It highlights the role of the hematologist in offering guidance for choosing differentiated approaches in relation to specific circumstances and is intended to provide them with a useful tool for sharing the decision-making process with their patients. Probably, the greatest risk to avoid for a patient with suspected, ongoing or relapsed ITP - that is not severe enough to place him or her at risk for major bleeding - is to be infected in non-hospital and hospital healthcare settings. This risk must be carefully considered when adapting the diagnostic and therapeutic approach. More in detail, the document first addresses the appropriate management for COVID-19 negative patients with newly diagnosed ITP or who experience a relapse of previous ITP, according to first and second lines of treatment and then the management of COVID-19 positive patients according to their severity, from paucisymptomatic to those requiring admission to Intensive Cure Units (ICU). The pros and cons of the different treatments required to correct platelet count are discussed, as are some specific situations, including chronic ITP, splenectomy, thromboembolic complication and anti COVID-19 vaccination.

中文翻译:

在COVID-19大流行期间管理ITP患者的实用建议。

当前的COVID-19大流行需要重新审视我们对主要血液疾病(包括ITP(免疫性血小板减少症))的治疗方法,从而激起了针对多种疾病的实用指南的产生。本报告介绍了有关ITP管理的基于共识的实用指南的更新版本,该指南适用于意大利的卫生系统和社会环境。它强调了血液学家在提供针对特定情况选择差异化方法的指导方面的作用,旨在为血液学家提供与患者共享决策过程的有用工具。对于疑似可疑患者,可能最大的风险是要避免,正在进行或复发的ITP-严重程度不足以使他或她面临大出血的危险-将在非医院和医院的医疗机构中感染。在采用诊断和治疗方法时必须仔细考虑这种风险。更详细地讲,该文件首先根据第一和第二种治疗方法,针对新诊断ITP或经历过先前ITP复发的COVID-19阴性患者进行适当管理,然后根据以下方法处理COVID-19阳性患者从严重症状到需要入院重症监护病房(ICU)的严重程度。讨论了纠正血小板计数所需的不同治疗方法的利弊,以及某些特殊情况,包括慢性ITP,脾切除术,
更新日期:2021-05-21
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