Hemolytic Anemia Complicating COVID-19 Infection (original) (raw)
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Clinicopathological Parameters of Haemolytic Anaemia in COVID-19 Infection: A Series of Three Cases
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022
Coronavirus Disease 2019 (COVID-19) patients show various haematological abnormalities like cytopenia and coagulation disorders. Corona virus can induce an inflammatory state, leading to extensive coagulation manifestations. Association between COVID-19, Autoimmune Haemolytic Anaemia (AIHA) and thrombotic state is still the subject of extensive research. In this study, three cases of haemolytic anaemia are discussed. First case was a 28-year-old female with a history of abruptio placentae who presented with complaints of generalised weakness and oliguria for five days. She was diagnosed as thrombotic microangiopathy based on peripheral smear finding of schistocytes and spherocytes and few polychromatophils and normal prothrombin time (International Normalized Ratio (INR)) with very high D-dimer levels on coagulation profile. Second case was of a 25-year-old female who presented with complaints of fatigue, rashes, dark urine, nausea and abdominal pain. She was diagnosed as a case of ...
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...
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
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...
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.
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.
Infectious Disease Reports
Warm autoimmune hemolytic anemia (AIHA) is a rare complication of COVID-19 infection. We report a case of warm AIHA in a patient with COVID-19 pneumonia treated with methylprednisolone and several red blood cell transfusions. Despite treatment of the warm AIHA, the patient’s reticulocyte count remained low, and his biochemical markers were suggestive of pure red cell aplasia, which was later attributed to a concurrent parvovirus B19 infection. This case highlights an unusual situation of two separate hematological processes caused by two separate and simultaneous viral infections.
Anemia in patients with Covid-19: pathogenesis and clinical significance
Clinical and Experimental Medicine
COVID-19 patients typically present with lower airway disease, although involvement of other organ systems is usually the rule. Hematological manifestations such as thrombocytopenia and reduced lymphocyte and eosinophil numbers are highly prevalent in COVID-19 and have prognostic significance. Few data, however, are available about the prevalence and significance of anemia in COVID-19. In an observational study, we investigated the prevalence, pathogenesis and clinical significance of anemia among 206 patients with COVID-19 at the time of their hospitalization in an Internal Medicine unit. The prevalence of anemia was 61% in COVID-19, compared with 45% in a control group of 71 patients with clinical and laboratory findings suggestive of COVID-19, but nasopharyngeal swab tests negative for SARS-CoV-2 RNA (p = 0.022). Mortality was higher in SARS-CoV-2 positive patients. In COVID-19, females had lower hemoglobin concentration than males and a higher prevalence of moderate/severe anemia (25% versus 13%, p = 0.032). In most cases, anemia was mild and due to inflammation, sometimes associated with iron and/or vitamin deficiencies. Determinants of hemoglobin concentration included: erythrocyte sedimentation rate, serum cholinesterase, ferritin and protein concentrations and number of chronic diseases affecting each patient. Hemoglobin concentration was not related to overall survival that was, on the contrary, influenced by red blood cell distribution width, age, lactate dehydrogenase and the ratio of arterial partial oxygen pressure to inspired oxygen fraction. In conclusion, our results highlight anemia as a common manifestation in COVID-19. Although anemia does not directly influence mortality, it usually affects elderly, frail patients and can negatively influence their quality of life. Keywords COVID-19 • Anemia • Oxygen partial pressure/oxygen concentration • Red blood cell distribution width • Anemia of inflammation * Gaetano Bergamaschi
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.
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...