For those with a prior COVID‐19 infection, molecular mimicry with autoantibodies to ADAMTS‐13 is likely the predominant trigger, but having an underlying predisposition (prior episode of TTP, genetic predisposition to autoimmune conditions, or breast cancer history) creates an environment that could be a possible trigger for aTTP. This evidence concerns the gene ADAMTS13 and thrombotic thrombocytopenic purpura.