Thrombocytopenia in coronavirus disease-2019 (COVID-19) can be attributed to multiple factors. Most often it is disease related. It is usually mild and if severe often associated with severe COVID-19 disease. It can also be due to drugs (Remdesivir, Tocilizumab) or coinfection with other viruses. Here we report two cases of severe thrombocytopenia in COVID-19 due to dengue coinfection. Most often the thrombocytopenia in dengue is self-resolving, and a careful “wait and watch” should suffice unlike COVID-19, where steroids can help if the cytopenia is due to cytokine storm or immune-mediated effects.
Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol 2020;99(6):1205–1258. DOI: 10.1007/s00277-020-04019-0.
Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clin Chim Acta 2020;506:145–148. DOI: 10.1016/j.cca.2020.03.022.
Sadr S, SeyedAlinaghi S, Ghiasvand F, Hassan Nezhad M, Javadian N, Hossienzade R, et al. Isolated severe thrombocytopenia in a patient with COVID-19: a case report. IDCases 2020;21:e00820. DOI: 10.1016/j.idcr.2020.e00820.
Chen W, Yang B, Li Z, Wang P, Chen Y, Zhou H. Sudden severe thrombocytopenia in a patient in the recovery stage of COVID-19. Lancet Haematol 2020;7(8):e624. DOI: 10.1016/S2352-3026(20)30175-7.
Malik J, Javaid M, Majedi O, Ishaq U, Zahid T. Paying in blood: a case of thrombocytopenia in Covid-19. Cureus 2020;12(8):e9791. DOI: 10.7759/cureus.9791.
Varghese B, Kumaran JA. Trend of dengue fever in COVID-19 period: observation from Kerala, India. Int J Commun Med Publ Health 2020;7(8):3307. DOI: 10.18203/2394-6040.ijcmph20203419.
Wollina U, Karadağ AS, Rowland-Payne C, Chiriac A, Lotti T. Cutaneous signs in COVID -19 patients: a review. Dermatol Ther 2020;33(5):e13549. DOI: 10.1111/dth.13549.
Thomas E, John M, Kanish B. Mucocutaneous manifestations of dengue fever. Indian J Dermatol 2010;55(1):79. DOI: 10.4103/0019-5154.60359.
Miah MDA, Husna A. Coinfection, coepidemics of COVID-19, and dengue in dengue-endemic countries: a serious health concern. J Med Virol 2020. Online ahead of print. DOI: 10.1002/jmv.26269.
Yan G, Lee CK, Lam LTM, Yan B, Chua YX, Lim AYN, et al. Covert COVID-19 and false-positive dengue serology in Singapore. Lancet Infect Dis 2020;20(5):536. DOI: 10.1016/S1473-3099(20)30158-4.