COVID19 Infection in A Patient Undergoing Treatment for Paroxysmal Nocturnal Hemoglobinuria (PNH) with Ravulizumab

Shikdar, S.; Borogovac, Azra; Mohamad, Elabdallah; Khawandanah, Mohamad

doi:10.21203/rs.3.rs-84187/v1

Cited by 3 publications

(7 citation statements)

References 7 publications

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“…Occasional reports of PNH patients with COVID-19 show that patients on anticomplement therapy did not develop pneumonia, while others (treatment naive) did, suggesting protective properties of anticomplement drugs in COVID-19. 19,21,22 Also, none of the reported PNH patients developed VTE. 19,21,22 In light of this, several ongoing studies are evaluating eculizumab and other anticomplement therapies in severe COVID-19 patients with initial promising results.…”

Section: Discussionmentioning

confidence: 96%

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COVID-19 Presented with Deep Vein Thrombosis in a Patient with Paroxysmal Nocturnal Haemoglobinuria

et al. 2021

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Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired clonal haematological disease characterized by complement-mediated haemolysis, bone marrow failure and venous thrombosis. Anticomplement therapy eculizumab improves survival and reduces complications. Severe acute respiratory distress syndrome corona virus 2 (SARS-CoV-2) disease 2019 (COVID-19) is associated with high incidence of both venous and arterial thrombosis in hospitalized patients with pneumonia. Deep venous thrombosis (DVT) as the presenting symptom of COVID-19 is a rare event. We describe a well-controlled PNH patient on eculizumab for more than 5 years who presented with DVT, while on warfarin, as the first sign of COVID-19. To our knowledge, this is the first described case of DVT in a PNH patient with COVID-19.

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Section: Discussionmentioning

confidence: 96%

“…19,21,22 Also, none of the reported PNH patients developed VTE. 19,21,22 In light of this, several ongoing studies are evaluating eculizumab and other anticomplement therapies in severe COVID-19 patients with initial promising results. [23][24][25][26][27] Consistent with previous results, our patient did not develop pneumonia.…”

Section: Discussionmentioning

confidence: 96%

COVID-19 Presented with Deep Vein Thrombosis in a Patient with Paroxysmal Nocturnal Haemoglobinuria

et al. 2021

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“…Approximately, 35% of patients die within 5 years if untreated due to thrombosis and related complications. [ 10 , 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…PNH, although rare, can be fatal and includes an increased risk of thromboembolism and severe end-organ damage. Approximately, 35% of patients die within 5 years if untreated due to thrombosis and related complications [10,11] …”

Section: Discussionmentioning

confidence: 99%

“…Approximately, 35% of patients die within 5 years if untreated due to thrombosis and related complications. [10,11] The complement system activation is a critical component in the sequalae of COVID19 infection. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state.…”

Section: Discussionmentioning

confidence: 99%

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COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria

Sokol¹,

Nehaj

Mokáň

et al. 2021

Medicine

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Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, life-threatening hemopoietic stem cell disorder characterized by the triad of hemolytic anemia, thrombosis, and impaired bone marrow function. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state. Patient concerns: A 27-year-old Caucasian man with PNH presented to the Emergency Department of our hospital with acute onset shortness of breath, cough and blood in urine. Diagnosis: The patient was diagnosed with acute hemolytic exacerbation of PNH complicated with moderate COVID19 pneumonia. Outcomes: The patient was initiated with an anticoagulant unfractionated heparin, dexamethasone, and cefuroxime injection. His symptoms quickly resolved, and he was discharged after 5 days. Conclusion: The complement system activation is a critical component in the sequalae of COVID19 infection. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state. Notably, C5a concentration was noted to be higher in patients with COVID19 infection. The use of complement inhibitors to attenuate immune mediated damage in COVID19 nevertheless represents a very interesting theoretical approach. However, careful consideration as to which patients may benefit will be required and the outcome of clinical trials needed.

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Severe Hemolytic Exacerbations of Chinese PNH Patients infected SARS-CoV-2 Omicron

Yang,

Chai,

Gong

et al. 2024

Preprint

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Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by hemolytic anemia, bone marrow failure, thrombophilia. COVID-19, caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with many variants including Omicron. This study depicted demographic and clinical characteristics of 20 PNH patients with SARS-Cov2 Omicron infection. All the patients hadn’t previously been administrated with complement inhibitors. They all were with high disease activity (HDA), and LDH level exceeded any documented since the diagnosis of PNH, and those reported in the literature for previously stable treatment with complement inhibitors. D-dimer level elevated in 10 patients. 2 patients developed mild pulmonary artery hypertension. Glomerular filtration rate (GFR) declined in 5 patients. 1 patient developed acute renal failure and underwent hemodialysis. Anemia and hemolysis were improved in 5 patients treated with eculizumab. Hemolytic exacerbation of PNH with COVID-19 is severe and eculizumab may be an effective treatment.

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COVID19 Infection in A Patient Undergoing Treatment for Paroxysmal Nocturnal Hemoglobinuria (PNH) with Ravulizumab

Cited by 3 publications

References 7 publications

COVID-19 Presented with Deep Vein Thrombosis in a Patient with Paroxysmal Nocturnal Haemoglobinuria

COVID-19 Presented with Deep Vein Thrombosis in a Patient with Paroxysmal Nocturnal Haemoglobinuria

COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria

Severe Hemolytic Exacerbations of Chinese PNH Patients infected SARS-CoV-2 Omicron

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