The COVID-19 pandemic has reshaped daily life around the world. For many people living with chronic health conditions, the pandemic has been especially concerning.
COVID-19 is a contagious respiratory disease. The virus that causes it can bring about mild to serious infections — and in some cases, potentially life-threatening complications.
If you have immune thrombocytopenia (ITP), you may have questions about how the condition affects the risk of developing COVID-19 or related complications. We consulted expert sources to bring you the guidance you need, including specific steps you can take to help protect your health.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub to access the most recent information on the COVID-19 outbreak.
According to the Platelet Disorder Support Association, ITP itself doesn’t appear to increase a person’s risk of developing COVID-19.
However, certain treatments for ITP affect your immune system and may alter your body’s ability to fight off infection.
These immune-suppressing treatments include:
- steroids, such as prednisolone, dexamethasone, and deflazacort
- rituximab (Rituxan, MabThera), a B-cell depletion therapy
- immunosuppressive drugs, such as azathioprine (Imuran, Azasan), cyclosporine (Sandimmune), and mycophenolate mofetil (Cellcept)
- chemotherapy drugs, such as vincristine (Oncovin) and cyclophosphamide (Cytoxan)
- splenectomy, a procedure in which your spleen is removed
If you’re taking treatments that suppress your immune system and you develop COVID-19, you may have a higher risk of developing a severe infection or certain complications.
However, much is still unknown. Don’t stop a treatment without consulting your doctor. More research is needed to learn how different ITP treatments affect people with COVID-19.
Whether your doctor will recommend a treatment change depends on many factors, including your medical history and ITP symptoms.
To learn more about how doctors are weighing ITP treatment decisions with the risk of COVID-19, Healthline spoke to Alice Ma, MD, FACP, a professor of medicine in the Division of Hematology/Oncology at UNC School of Medicine in Chapel Hill, North Carolina.
One major consideration is how long someone has been living with ITP. Treatment advice may differ based on whether a person is newly diagnosed or they’ve managed chronic ITP for years.
Newly diagnosed ITP
If you receive a new diagnosis of ITP during the COVID-19 pandemic, your doctor might avoid prescribing steroids, rituximab, or other immune-suppressing treatments as a first-line therapy.
“Immunosuppressing ITP treatment may predispose [a person] to severe COVID complications,” Dr. Ma told Healthline. “For this reason, the American Society of Hematology guidelines recommend against the routine use of steroids and rituximab.”
Instead, your doctor might prescribe intravenous immune globulin (IVIg), thrombopoietin receptor agonists (TRAs), or a combination of both treatments, Dr. Ma said.
TRAs include avatrombopag (Doptelet), eltrombopag (Promacta), and romiplostim (Nplate).
Chronic ITP
If you have chronic ITP, your doctor will consider how you’re responding to your current treatment plan before deciding whether to make a change.
If your current treatment plan is working well for you, your doctor will likely advise you to stick with it. Changing treatments may put you at risk of a relapse or worsened ITP.
If you’re taking immune-suppressing medications, your doctor can help you learn how to manage your risk of infection — including COVID-19.
“If someone is already on immunosuppression and is doing well, we are not changing therapies,” Dr. Ma said.
“We are asking these folks to be much more careful in their physical distancing — washing hands, wearing a mask, and trying to stay at home as much as possible,” she added.
Monitoring platelet levels
During the COVID-19 pandemic, your doctor may order blood tests less often than usual to check your platelet counts.
This will help limit your exposure to healthcare facilities, which may reduce your chances of being exposed to the virus that causes COVID-19.
Some people with ITP may need to continue frequent blood testing to monitor their platelet levels. Ask your doctor how often you should have your platelet levels checked.
Anyone who develops COVID-19 may experience cough, fatigue, fever, or other symptoms of the condition. Sometimes, it causes delirium, difficulty breathing, and serious complications.
Like any viral infection, COVID-19 may cause your platelet levels to drop. If you’re in remission from ITP, this may cause ITP symptoms to return or get worse.
Some people with severe cases of COVID-19 develop secondary bacterial infections, which may cause pneumonia or other complications. If your spleen has been removed or you’re taking steroids to treat ITP, you might have a higher risk of a secondary infection.
COVID-19 has also been linked to increased risk of blood clots in the lungs and other parts of the body. Certain ITP treatments have been linked to increased risk of blood clots, too. However, the American Society of Hematology reports that there’s currently no evidence that people receiving treatment for ITP are more likely to develop a blood clot as a complication of COVID-19.
There are several steps you can take to lower your risk of developing COVID-19 and passing the virus to other people.
Practice physical distancing
To reduce your risk of developing COVID-19, it’s essential to practice physical distancing. (This is also sometimes called social distancing.)
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Dr. Ma echoed this advice: “Stay home. Have everyone who lives with you stay home, as much as possible.”
“If you want to get out, take walks during times and places where there aren’t a lot of other people around,” she added.
Practicing physical distancing doesn’t mean avoiding social contact. Stay in touch with family and friends outside your household through phone calls, social media, and video chats.
Clean your hands and surfaces
If you touch a surface or object contaminated with the virus that causes COVID-19, the virus may transfer to your hand. If you then touch your eyes, nose, or mouth, you may transfer it to your respiratory system.
That’s why it’s important to wash your hands with soap and water, especially when you’ve been spending time in public places. If you don’t have soap and water available, use an alcohol-based hand rub or sanitizer.
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Try not to touch your eyes, nose, or mouth with unwashed hands.
Wear a face mask
If you do leave your home, Dr. Ma recommends wearing a face mask.
Wearing a mask may not prevent you from contracting the virus, but it could help protect people near you. It’s possible to have the virus without having symptoms of it.
If you do get the virus without realizing it, wearing a mask may help stop its spread to other people.
Wearing a mask isn’t a substitute for physical distancing. It’s important to keep your distance from other people, even if you and those around you are wearing masks.
Take precautions after splenectomy
If you’ve had your spleen removed, stay up to date on your vaccinations and take any preventive antibiotic medications your doctor prescribed for you. This may help prevent a secondary infection if you do develop COVID-19.
Call your doctor right away if you develop potential signs or symptoms of COVID-19, such as:
- fever
- fatigue
- dry cough
- muscle aches
- headache
- diarrhea
- loss of taste or smell
- difficulty breathing
If you have a mild case of COVID-19, you may be able to recover at home without treatment.
In some cases, people develop serious infections that require emergency care.
Seek emergency medical treatment right away if you develop:
- difficulty breathing
- persistent pressure or pain in your chest
- confusion that you didn’t have before
- trouble waking or staying awake
- bluish face or lips
You should also seek immediate medical attention if you develop signs or symptoms of an ITP-related emergency, such as severe or uncontrollable bleeding.
“Don’t put off serious problems for fear of COVID,” Dr. Ma advised. “Go to the hospital for urgent or emergent care. The ERs are set up to handle infected folks and to try to keep infected folks away from other patients.”
Living with ITP doesn’t appear to increase your risk of developing COVID-19, but some treatments for ITP might raise your risk of experiencing a severe infection if you do get it.
Developing COVID-19 may also cause your platelet levels to drop, which may cause a relapse or worsening of ITP symptoms.
Practicing physical distancing and good hygiene is important for reducing your risk. Ask members of your household to take precautions to help protect you, too.