Re: Late diagnosis of COVID-19 and hypercoagulable state.

Abstract

We would like to share ideas on the publication “Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report [1].” According to Desdiani, the increased mortality rate of COVID-19 patients is mostly due to a hypercoagulable state, and early recognition and therapy of the hypercoagulable state, including the use of LMWH, can lessen the severity of COVID-19 symptoms [1]. The patient was first diagnosed with dengue hemorrhagic fever and had thrombocytopenia and increased liver transaminase tests. The delayed diagnosis of COVID-19 because of misclassification as another infec- tion is a serious issue. An early study during the COVID-19 outbreak suggested that misdiagnosis as dengue fever could be a factor in COVID-19 diagnosis delays [2]. In the present study, the hypercoagula-bility might be due to the disease progression. This finding shows the difficulty in differential diagnosis between the COVID-19 and dengue since dengue can be the cause of thrombotic thrombocytopenic purpura and multiple inflammatory syndrome [3]. Finally, the chance of concurrent medical problems between COVID-19