ITP relapses and clinical manifestations
During hospitalization, 13 (43.3%) patients developed ITP relapses. The median time from COVID-19 diagnosis to the ITP relapse time was two days (IQR: 1-6). The median lowest platelet count was 60 x109/L (IQR: 43-74) and the median time to lowest platelet count was three days (IQR: 1.5-8.5) after COVID-19 diagnosis. Figure 1 shows platelet counts during the admission. Table 1 summarizes the clinical characteristics, treatment lines, and outcomes of all chronic ITP patients who developed relapses. Among the patients who developed ITP relapses, seven (53.8%) patients were male, and the median age was 70 year old (IQR: 67-78). Three (23.1%) patients received ITP treatment in the past during their life, one patient was on Eltrombopag, one patient was on steroids and IVIG, and the last one was on steroid, Eltrombopag, romiplostim, and IVIG. Five (38.5%) patients developed six bleeding complications, of which three (50%) were GI bleed, two (33.3%) were skin purpura and one (16.7%) was hemoptysis. None of the bleeding events were major or required blood transfusion.