Significance statement:
We investigated the clinical impacts of COVID-19 infections on the rate of disease relapses among chronic immune thrombocytopenia (ITP) patients admitted to the Cleveland Clinic enterprise. Treatment guidelines for COVID-19 associated ITP or diseases relapses are limited due to lack of experience. We also reported different treatment used in patients who relapsed and response rates to different treatment protocols, including observation, which is important to guide treatment in this unique patients population.