Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 15 1 2021 01 13 72 74 Maryam Darnahal Department of Hematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamed Azhdari Tehrani Department of Hematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Vaezi Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran Shirin Haghighi Department of Hematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2020 10 26 2020 11 21 Endothelial injury by toxins, drugs, immune complexes leads to activation of coagulation cascade and thrombosis, which result in platelet consumption and red blood cell injury. These thrombotic microangiopathies can potentially injure numerous organs and result in organ dysfunction. In this case, we present the fourth reported patient with thrombotic thrombocytopenic purpura associated with COVID-19. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1451 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1451/861