Coronavirus disease 2019 (COVID-19) is caused by the novel SARS-CoV-2 virus and has been declared a pandemic on the 9th of March by the WHO. A hallmark of COVID-19 management is supportive care and there is still no convincing evidence for a treatment which will reduce mortality. Severe COVID-19-associated sepsis characterized by acute respiratory distress syndrome (ARDS), secondary bacterial pneumonias, thrombotic complications, myocarditis, and gastrointestinal involvement are more prevalent in those with comorbidities such as hypertension, diabetes, cardiac disease, cancer and age >70 years. 1,2 There is a paucity of data on COVID-19's impact on bone marrow transplant patients. Herein we reflect on the course of seven bone marrow transplant recipients in Birmingham Heartlands Hospital who have been found positive for SARS-CoV-2 RNA on real time polymerase chain reaction (RT-PCR) from nasopharyngeal swabs done in the context of symptoms (fever, cough, dyspnoea, and fatigue) or inpatient contact. The median age was 61 years (range 40-74). Out of these, five (71%) were female and two (29%) were male. The median time from stem cell infusion to the diagnosis of SARS-CoV-2 virus was 61 days (range 7-343). Patients were screened for SARS-CoV-2 via an RT-PCR-based technique.

COVID-19 has been declared as a global pandemic, affecting more than a hundred countries in a matter of weeks and claiming many lives up until now. The clinical spectrum ranges from asymptomatic carriers to symptomatic patients with mild symptoms and patients requiring intensive care unit (ICU) admission at the other extreme. Variable clinical presentations have been reported, most commonly involving the chest with shortness of breath being most common. Less commonly it has also been reported with gastrointestinal and neurological manifestations. Haematological manifestations in symptomatic COVID-19 patients include severe leukopenia with lymphopenia and mild thrombocytopenia with platelet counts ranging between 100-150 9 10 9 /l. [1][2][3][4] We hereby report a case series of three patients; the first two patients presented with severe thrombocytopenia and were subsequently found to be COVID-19positive. The third case emphasises the presentation of severe thrombocytopenia as a marker of severity and poor prognosis in symptomatic COVID-19 patients.

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A single 1 g/kg dose of intravenous immunoglobulin is a safe and effective treatment for immune thrombocytopenia; results of the first HaemSTAR 'Flash-Mob' retrospective study incorporating 961 patients Key Messages 1 A one off 1 g/kg infusion of intravenous immunoglobulin (IVIg) may be as effective as two consecutive 1 g/kg doses. 2 This is the largest ever study of the efficacy of IVIg for immune thrombocytopenia (ITP). 3 There is poor adherence to the 2016 NHS England guidelines on IVIg dosing.