Clinicopathological Parameters of Haemolytic Anaemia in COVID-19 Infection: A Series of Three Cases (original) (raw)
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Bangabandhu Sheikh Mujib Medical University Journal, 2021
Autoimmune hemolytic anaemia (AIHA) can be caused by many diseases like connective tissue disease, lymphoproliferative disorder, certain infections and various medications. The coronavirus disease 19(COVID-19) can cause an increased risk of thrombosis. But, the association of AIHA with COVID-19 is not well understood. Here, in this case report a 45-year-old man who presented with fever, cough, anaemia and splenomegaly. On further investigation, he was confirmed as severe COVID-19 case with AIHA. Subsequently he was managed with prednisolone with good results. BSMMU J 2021; 14 (COVID -19 Supplement): 57-59
Hemolytic Anemia Complicating COVID-19 Infection
Journal of Hematology, 2021
Coronavirus disease 2019 (COVID-19) has been associated with a spectrum of reported hematological complications ranging from immune cytopenias to thromboembolic manifestations of coagulopathy. Moreover, there have been documented cases of hemolytic anemia associated with COVID-19 infection which have been mainly attributed to development of autoantibodies. We report a case of an African-American patient who presented with hemolytic anemia in the second week after his COVID-19 diagnosis. Throughout this report, we explore the potential immune and non-immune etiologies that contributed to the patient's hemolytic anemia in the setting of COVID-19 infection guided by a review of literature.
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Clinical manifestation of coronavirus disease (COVID-19) could be asymptomatic, mild to severe, even mortality. Although various hematological complications associated with COVID-19 infection have been reported, the finding of autoimmune hemolytic anemia (AIHA) is a novel case. CASE REPORT: A 59-year-old woman was admitted to our emergency room because of a 5-day period of fever with cough and shortness of breath. At admission, she was takipnea, jaundice, and had an oxygen saturation of 60% on room air. Laboratory studies showed hemoglobin (Hb) 3.68 g/dL, high reticulocyte (14.4%), and hyperbilirubinemia. Chest X-ray showed bilateral pneumonia with positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. Although she got packed red cell (PRC) transfusions in 7 days, her Hb remained low and bilateral infiltrate still increased. That’s why we considered direct Coombs test and it returned positive. AIHA was diagnosed and treatment with hydroc...
Young Woman With Recurrent Autoimmune Hemolytic Anemia And Covid-19: A Case Report
International Journal of Research Publications
Introduction: The clinical manifestations of autoimmune hemolytic anemia can be moderate or severe but if the anemia is associated with infection with the SARS-CoV-19 virus it can lead to higher rates of paralysis or even death. In this case, a young woman experiencing recurrent autoimmune hemolytic anemia accompanied by infection with the SARS-CoV-19 virus is a new case. Case Report: A 20-year-old young woman came to our emergency department with a complaint of a limp body with fever for 1 day. The patient looks pale, tired and lethargic. Menstrual history ± 2 weeks. The patient had a history of autoimmune hemolytic anemia, 11 months ago. Lab tests showed hemoglobin (Hb) 3.7 g/dl, RT-PCR (+), x-ray photos of thorax appeared normal. Patients are given 4 prc transfusion bags in 1 day Hb increased to 10.1 g/dl. We performed an examination of the removal of peripheral blood and obtained the results of agglutination (+), spherocytes (+), polychromate (+), microcysocytes (+). Direct Coomb's Test (+). Patients diagnosed with AIHA and therapy with dexameathasone 5 mg IV as much as 3x / day. After 4 days, the patient goes home without any complaints. Conclusion: SARS CoV-2 infection during this pandemic can be considered a recurrent AIHA trigger in adolescent women, besides that it can increase comorbidities, also cause a more severe inflammatory response, and injuries to organs, when compared to those that patients do not suffer from anemia.
Hematologic disorders associated with COVID-19: a review
Annals of Hematology, 2021
Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2. Primarily an infection of the lower respiratory tract, it is now well known to cause multisystem abnormalities. Hematologic manifestations constitute a significant area of concern. Severe acute respiratory syndrome coronavirus 2 infects monocytes and endothelial cells leading to a complex downstream cascade, cytokine storm, and eventual intravascular thrombosis. Coronavirus disease 2019 causes lymphopenia, neutrophilia, and thrombocytopenia. Prophylactic anticoagulation is vital in patients with coronavirus disease 2019, as its effect on the coagulation system is associated with significant morbidity and mortality. The disease can cause both arterial and venous thromboses, especially pulmonary embolism and pulmonary microthrombi. A high index of suspicion is indispensable in recognizing these complications, and timely institution of therapeutic anticoagulation is vital in treating them. Virus-induced disseminated intravascular coagulation is uncommon but shares some similarities to sepsis-induced disseminated intravascular coagulation. Marked elevations in hematologic biomarkers such as lactate dehydrogenase, D-dimer, ferritin, and C-reactive protein are associated with worse outcomes. Understanding the pathophysiology and recognizing factors associated with poor prognosis are crucial in improving patient outcomes with coronavirus disease 2019.
Autoimmune Hemolytic Anemia After Inactivated Virus COVID-19 Vaccination: A Report of 2 Cases
Ramathibodi Medical Journal
Very few cases of autoimmune hemolytic anemia (AIHA) have been reported after mRNA COVID-19 vaccinations. But herein we found 2 cases of AIHA after inactivated virus COVID-19 vaccination. Case 1: a 47-year-old Thai woman suffered from malaise, fatigue, and feverish feeling since the evening of the day of the first dose of inactivated virus COVID-19 vaccination (Sinopharm). She did not have any serious health problem prior this illness. Physical examination revealed marked pallor and body temperature was 38.1°C. Blood tests showed hemoglobin (Hb) 55 g/L, white blood cell (WBC) 12.2 × 109/L, platelet 310 × 109/L, nucleated red blood cell (RBC) 8/100 WBC, reticulocyte count 25.0%, direct antiglobulin test-4+ positive, indirect antiglobulin test-2+ positive. She was diagnosed with severe AIHA and well responsive to steroid therapy. Case 2: a 78-year-old Thai woman felt fatigue without fever 3 days after the second dose of inactivated virus COVID-19 vaccine (Sinopharm). Her underlying di...
Journal of Medical Case Reports, 2020
Background In December 2019, a new coronavirus (named severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) spread from China, causing a pandemic in a very short time. The main clinical presentation of SARS-CoV-2 infection (COVID-19, coronavirus disease-2019) is pneumonia, but several cardiovascular complications may also occur (e.g., acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure and cardiogenic shock). Direct or indirect mechanisms induced by SARS-CoV-2 could be implicated in the pathogenesis of these events. Case presentation We report herein the third case of COVID-19 autoimmune haemolytic anaemia (AIHA) reported so far, which occurredwithout any other possible explanations in a Caucasian patient. The patient also suffered from ST-elevation myocardial injury. Conclusions Both complications occurred quite late after COVID-19 diagnosis and were probably precipitated by systemic inflammation, as indicated by a significant delayed increase in...
Immune thrombocytopenia, severe hematological consequence in a patient with COVID‑19: A case report
Experimental and Therapeutic Medicine, 2021
Since the first appearance of coronavirus disease 2019 (COVID-19), multiple studies have focused on this novel coronavirus. Within a few months, the clinical and paraclinical manifestations and the mechanisms by which these changes are induced were elaborated. Clinically, the virus mainly causes the common cold, but can also result in severe or fatal pneumonia/acute respiratory syndrome. Regarding the biological changes, similar to any other virus, it can lead to a reduced lymphocyte count. The second most common change is represented by a reduced thrombocyte count. Furthermore, most patients have blood clotting abnormalities, inflammatory syndrome, raised D-dimer and lactate dehydrogenase levels. Detection of immune thrombocytopenia in asymptomatic patients who tested positive for COVID-19 justifies the need to perform differential diagnosis and testing for COVID-19. Typically, patients with severe forms of COVID-19 develop mild thrombocytopenia, while severe thrombocytopenia is rarely reported. The aim of this case report was to present the situation in which one asymptomatic patient who tested positive for COVID-19 developed severe immune thrombocytopenia.
COVID-19 Associated Coagulopathy and Thrombotic Complications
Clinical and Applied Thrombosis/Hemostasis
The SARS-CoV-2 virus caused a global pandemic within weeks, causing hundreds of thousands of people infected. Many patients with severe COVID-19 present with coagulation abnormalities, including increase D-dimers and fibrinogen. This coagulopathy is associated with an increased risk of death. Furthermore, a substantial proportion of patients with severe COVID-19 develop sometimes unrecognized, venous, and arterial thromboembolic complications. A better understanding of COVID-19 pathophysiology, in particular hemostatic disorders, will help to choose appropriate treatment strategies. A rigorous thrombotic risk assessment and the implementation of a suitable anticoagulation strategy are required. We review here the characteristics of COVID-19 coagulation laboratory findings in affected patients, the incidence of thromboembolic events and their specificities, and potential therapeutic interventions.
A Case of COVID-19 Infection Associated with Severe Cold Agglutinin Autoimmune Haemolytic Anaemia
Clinical Medical Reviews and Case Reports, 2021
Background: COVID-19 is known to cause systemic disease with multiple organ dysfunctions. COVID-19 associated immune-mediated phenomena such as autoimmune haemolytic anaemia has been identified previously with rare incidence. However, the association between COVID-19 infection and autoimmune haemolytic anaemia is not fully evaluated. Case presentation: Here, we present a case of a previously well patient who developed severe cold agglutinin hemolytic anemia during the course of COVID-19 infection. Although there were no thrombotic complications, he developed acute kidney injury and COVID-19 lung involvement during the course of the disease. He was successfully treated with blood transfusion, oxygen therapy, corticosteroids and antibiotics and, best supportive care. Conclusion: Although it is an uncommon presentation, clinicians need to be aware of COVID-19 infectionassociated autoimmune manifestations including warm and cold type haemolytic anaemia. This case emphasizes the importance of an extensive diagnostic workup to identify autoimmune haemolytic anaemia in COVID-19 patients who could present with severe anaemia which requires timely management to save their lives.