While coronavirus disease 2019 (COVID-19)-associated thrombocytopenia is well-documented, its effects on immune thrombocytopenia (ITP) patients remain unclear. This study aimed to investigate the impact of COVID-19 infection on platelet (PLT) dynamics in chronic ITP patients. This retrospective study analyzed 21 persistent and chronic ITP patients before and after mild COVID-19 infection during China's December 2022 reopening, comparing platelet parameter changes with a focus on clinical characteristics of thrombopoietin receptor agonist (TPO-RA) treated patients. TPO-RA treated patients demonstrated transient platelet surges peaking at 1 week postinfection, returning to baseline within 2-3 weeks, contrasting sharply with thrombocytopenia patterns in non-ITP populations. This suggests synergistic effects between virus-induced inflammatory cytokines and TPO-RA may drive transient megakaryopoiesis. These findings underscore infection-related PLT fluctuations in ITP, necessitating monitoring for thrombotic and bleeding risks and TPO-RA dose optimization during infections. The authors have confirmed clinical trial registration is not needed for this submission.