Should we avoid heparin based anticoagulants in 'COVID-19 infection-vaccination related thrombosis'? Insights from the HIT like syndrome observed with infected cases. 

Background: Recent reports of the prothrombotic states announced in the recipients of the ChAdOx vaccine, similar to HIT sounded alarm bells internationally.The sole outcome parameter of this systematic review was to detect similar cases of Prothrombotic state in COVID-19 infected patientsMethodology: Embase, Medline and the Cochrane Central Register were used to search for specic keywords such as “COVID-19” OR “SARS-CoV-2” AND “Heparin induced thrombocytopenia” for relevant publications up to 1st of April 2021. The systematic review was performed using PRISMA protocol.Results: Nine cases reports/series have been identified including 18 cases, venous thrombosis was the commonest type of observed thrombosis accounting for 72 % of cases, the mean age of cases was 57±4.Conclusion: Similar episodes of HIT were detailed in several case reports of COVID patients. This suggests a common pathogenesis and warrants a screening of all COVID-19 patients presenting with thrombo-embolism using anti-PF4 antibodies and using non heparin based anticoagulants for their management.