Introduction <p>Due to immunosenescence, geriatric populations have a heightened vulnerability towards severe COVID-19 disease as well as disease complications during the course of illness. Insidious onset immune-mediated thrombocytopaenia during the recovery phase poses a significant challenge in its detection and management, especially among hospitalised elderly patients who might lack telltale signs till the platelet count becomes significantly reduced.</p> Case Report <p>A 93-year-old lady with underlying hypertension, a previous stroke, and recent right hip hemiarthroplasty was treated in our institution initially for COVID-19 infection. Prior to discharge, her repeated platelet level dropped precipitously from 182 × 10⁹/L to 6 × 10⁹/L within the span of 5&#xa0;days. Medications that could potentiate bleeding complications were withheld promptly after recognising the new onset thrombocytopaenia. Following the consultation with haematologist, she was diagnosed with immune-mediated thrombocytopaenia induced by COVID-19 infection and started on intravenous hydrocortisone therapy. Her platelet level recovered remarkably after 3&#xa0;days of intravenous hydrocortisone and she was eventually discharged well with a short course of prednisolone.</p> Conclusion <p>This report underscores the importance of recognising delayed onset thrombocytopaenia in COVID-19 among elderly patients, which is believed to have a viral induced immunological aetiology. It warrants a timely institution of steroidal therapy to increase the platelet count as well as prompt discontinuation of concurrent medications that could potentiate bleeding complications in the presence of critical thrombocytopaenia.</p>