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UCSF COVID-19 Adult Clinical Evaluation Guide - Updated April 10 2020

Clinical Presentation
• Fever: hospitalized pts but
Adult Clinical Evaluation ... lymphopenia in 33-85% • Platelets ... UCSF #COVID19 #Evaluation ... Guide #Diagnosis #Algorithm
Inherited Qualitative Platelet Defects
Bernard-Soulier Syndrome
 • Defect of adhesion due to a lack of GP Ib/IX/V
Inherited Qualitative Platelet ... Single isolated platelets ... without platelet ... failure Grey Platelet ... • Absence of platelet
Evaluation of suspected incomplete Kawasaki Disease

1. AHA consensus recommendations
2. Infants ≤6 months old on day ≥7
Evaluation of suspected ... elevation of ALT, platelets ... purposes of this algorithm ... Disease #Incomplete #Algorithm
Platelet disorders and Aggregometry
Glanzmann Thrombasthenia
 • Defective aggregation to all agonists except ristocetin
 • Normal platelet,
Platelet disorders ... ristocetin • Normal platelet ... count and platelet ... • Platelet flow ... Usually normal platelet
Idiopathic Thrombocytopenic Purpura 
Clinical:
 • Gingival 
 • Menorrhagia 
 • GI bleeding 
 • Intracranial
children) • Platelets ... extremely low platelet
Thrombocytosis - Differential Diagnosis
Platelet Count > 450
Reactive:
 • Anemia/blood loss (Fe deficiency)
 • Infection/Sepsis
 • Non-infectious
Differential Diagnosis Platelet ... Diagnosis #causes #Platelets
Thromboelastography (TEG) Based Management
 - If R time prolonged -> FFP 
 - If MA low
cryoprecipitate - If platelets ... < 50 -> platelet
Thromboelastography (TEG) based therapy and Management

If r time prolonged -> FFP
If MA low -> plts/cryoprecipitate (if
cryoprecipitate If platelets ... < 50 - > platelet
Indications for Transfusion
Packed RBCs
 • Hgb <7 g/dL or hematocrit <21% in a patient with uncompromised
hemoglobinopathy Platelets ... Prophylactically for platelet ... not transfuse platelets ... Platelet transfusions ... Management #RBCs #Platelets
Blood Product Components, Contents, Volume and Shelf Life

Whole blood (autologous or directed donations) - RBC and
WBC and platelets ... Hct 60% Platelet ... concentrate - Platelets ... Hct < .005) Platelet ... pheresis - Platelets