Coombs‐negative hemolytic anemia in a male with COVID‐19

Bae, Ju Young; Jeon, June; Hussein, Khalil I.; Lee, Merlin Sung

doi:10.1002/ccr3.4503

Cited by 5 publications

(11 citation statements)

References 17 publications

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“…COVID-19 infection has been reported to cause hematologic abnormalities, including cases of Coombs-negative hemolytic anemia. 2,3 Our patient presented with a unique combination of Coombs-negative hemolytic anemia and thrombocytopenia. Initially, we considered a broad range of differential diagnoses, including autoimmune, neoplastic, primary hematologic, and infectious causes.…”

Section: Discussionmentioning

confidence: 91%

“…It has been suggested that SARS-CoV-2 might interact with erythrocytes, leading to invasion and potential hemolysis. 3,4 This interaction could involve the CD147 spike protein, which facilitates binding to receptor cells and invasion. 8 However, further research is required to elucidate this mechanism and characterize it more comprehensively.…”

Section: Discussionmentioning

confidence: 99%

“…Given our patient’s persistent thrombocytopenia and declining hemoglobin levels necessitating transfusion support, we reviewed relevant cases to identify potential treatment options. Bae et al 3 reported a case of Coombs-negative hemolytic anemia that responded well to intravenous immunoglobulin (IVIG) therapy. Consequently, we administered IVIG to our patient as well.…”

Section: Discussionmentioning

confidence: 99%

“…1 While its primary impact is on the respiratory system, COVID-19 has also been associated with various hematologic abnormalities. Coombs-negative hemolytic anemia cases linked to COVID-19 infection have been reported in studies conducted by Neerukonda et al 2 and Bae et al 3 Lancman et al 4 conducted a study revealing elevated markers of hemolysis, particularly plasma hemoglobin (Hb) levels, in COVID-19 patients. Furthermore, platelet abnormalities have been observed in individuals infected with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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Hematologic Abnormalities After COVID-19 Infection: A Case of Coombs-Negative Hemolytic Anemia and Thrombocytopenia

Siegenthaler,

Ghelani,

Brady

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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The occurrence of hemolytic anemia in patients with active SARS-CoV-2 infection has been documented in medical literature. While relatively uncommon, there have been instances where this condition presents as a Coombs-negative hemolytic anemia. In this research study, we report a distinctive case of Coombs-negative hemolytic anemia and thrombocytopenia in a patient with a known history of COVID-19 infection. The patient demonstrated a favorable response to treatment involving the administration of steroids and intravenous immunoglobulin (IVIG) therapy. This case adds to the existing body of evidence regarding the hematological manifestations of SARS-CoV-2 infection, highlighting the importance of considering and managing hematological complications in patients with COVID-19.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hematologic Abnormalities After COVID-19 Infection: A Case of Coombs-Negative Hemolytic Anemia and Thrombocytopenia

Siegenthaler,

Ghelani,

Brady

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

View full text Add to dashboard Cite

show abstract

“…During the pandemic of the coronavirus disease 2019 (COVID-19), numerous multi-organ complications have been encountered from this infection in the clinical setting [ 1 ]. Hematological complications including autoimmune hemolytic anemia, venous thromboembolism, and disseminated intravascular coagulopathy (DIC) have been previously reported [ 2 ]. However, Coombs-negative hemolytic anemia is extremely rare with only three cases being reported so far [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Coombs-Negative Hemolytic Anemia in an Elderly COVID-19 Patient

Sanikommu,

Nadeem,

Ponnusamy

2024

Cureus

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COVID-19 infections are known to cause multi-organ complications. Hematological complications like autoimmune hemolytic anemia with a positive direct antiglobulin test (DAT), are commonly encountered. However, Coombs-negative hemolytic anemia is extremely rare. We report an interesting case of an elderly female with moderate-severe acute respiratory distress syndrome in the setting of COVID-19 pneumonia-causing Coombs-negative hemolytic anemia. This patient initially presented with sudden onset abdominal pain and vomiting, found to have an incarcerated inguinal hernia with small bowel obstruction (SBO) on imaging. Additionally, labs revealed positive COVID-19 antigen test and normocytic anemia. The hospital course was complicated by worsening hemolytic anemia and thrombocytopenia requiring blood products. Extensive workup for hemolysis in this patient with no prior hematological abnormalities, was negative for DAT and other conditions associated with or causative of hemolysis. At discharge, hemolytic parameters improved and on follow-up, hemoglobin returned to baseline, and repeat hemolytic parameters were normal. This case emphasizes the importance of considering SARS-CoV-2 along with other viral infections as one of the differentials for Coombs-negative hemolytic anemia.

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COVID-19 and Immune-Mediated RBC Destruction

Jacobs

Booth

2021

American Journal of Clinical Pathology

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Objectives To summarize the epidemiologic, clinical, and laboratory characteristics of autoimmune hemolytic anemia (AIHA) secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or vaccination. Methods We conducted a systematic review using standardized keyword search to identify all reports of SARS-CoV-2 infection or vaccination and AIHA across PubMed, Web of Science, Scopus, and Google Scholar through September 24, 2021. Results Fifty patients (mean [SD] age, 50.8 [21.6] years) diagnosed with coronavirus disease 2019 (COVID-19) and AIHA were identified. AIHA subtypes and number of patients were as follows: cold AIHA (n = 18), warm AIHA (n = 14), mixed-type AIHA (n = 3), direct antiglobulin test (DAT)–negative AIHA (n = 1), DAT-negative Evans syndrome (n = 1), Evans syndrome (n = 3), and subtype not reported (n = 10). Mean (SD) hemoglobin at AIHA diagnosis was 6.5 [2.8] g/dL (95% confidence interval, 5.7-7.3 g/dL). Median time from COVID-19 symptom onset to AIHA diagnosis was 7 days. In total, 19% (8/42) of patients with COVID-19–associated AIHA with reported outcomes were deceased. Four patients (mean [SD] age, 73.5 [16.9] years) developed AIHA following SARS-CoV-2 vaccination: Pfizer-BioNTech BNT162b2 vaccine (n = 2); Moderna mRNA-1273 vaccine (n = 1); undisclosed mRNA vaccine (n = 1). AIHA occurred after 1 dose in 3 patients (median, 5 days). Conclusions SARS-CoV-2 infection and vaccination are associated with multiple AIHA subtypes, beginning approximately 7 days after infectious symptoms and 5 days after vaccination.

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Coombs‐negative hemolytic anemia in a male with COVID‐19

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 5 publications

References 17 publications

Hematologic Abnormalities After COVID-19 Infection: A Case of Coombs-Negative Hemolytic Anemia and Thrombocytopenia

Hematologic Abnormalities After COVID-19 Infection: A Case of Coombs-Negative Hemolytic Anemia and Thrombocytopenia

Coombs-Negative Hemolytic Anemia in an Elderly COVID-19 Patient

COVID-19 and Immune-Mediated RBC Destruction

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