Patrick Kuhlman is a PGY-6 Resident, and Michael Goodman is an Assistant Professor, both in the Hematology- Oncology Fellowship Program; Julio Nasim is a PGY-5 Resident in the Infectious Disease Fellowship Program; all at Wake Forest University School of Medicine in Salem, North Carolina, and the W.G. (Bill) Hefner VA Medical Center in Salisbury, North Carolina. Correspondence: Patrick Kuhlman (pkuhlman@wakehealth.edu)
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
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This patient’s case highlights the presence of pan-pseudothrombocytopenia despite the use of a sodium citrate and heparin containing tube in a COVID-19 infection with multiorgan dysfunction. This developed 1 week prior to the patient suffering a STEMI despite therapeutic anticoagulation. Although the exact nature of CAC remains to be worked out, it is possible that platelet agglutination/clumping seen on the peripheral blood smear is representative of in vivo activity and serves as a harbinger for worsening thrombosis. The frequency of such phenomenon and efficacy of further interventions has yet to be explored.
