Leukemoid Reaction in a Patient With Severe COVID-19 Infection

Abstract

Leukemoid reaction is a rare clinical condition defined by marked leukocytosis with predominantly mature neutrophils. It is an uncommon condition with reported incidence of less than 1% in hospitalized patients. The major causes of leukemoid reaction are severe infection (clostridium difficile colitis, tuberculosis, or severe shigellosis), malignancies, intoxication, and severe hemorrhage. This article presents a case report of a 64-year-old female with severe COVID-19 infection who presented with marked leukocytosis. After extensive workup to exclude hematologic malignancy, the patient was diagnosed to have a leukemoid reaction.

Leukemoid Reaction in a young woman following a TAH-BSO with severe hemorrhage: A case report

“…[13] Case reports on severe covid 19 patients showed rare findings of leukemoid reaction irrespective of age, and were associated with high mortality. [14,15]…”

Case mistaken for leukemia after mRNA COVID-19 vaccine administration: A case report

“…However, to the best of our knowledge, there are no reports of severe leukocytosis. Cases of leukemoid reaction with COVID-19 have been reported, but there are no reports of similar cases related to vaccination[ 4 , 5 ]. The major causes of leukemoid reaction are severe infection, malignancies, intoxication, or hemorrhage.…”

Leukemoid Reaction in a Severe COVID-19 Patient

“…The most common causes are infections like Clostridium difficile , disseminated tuberculosis, and shigellosis. Other associated conditions are exposure to drugs (corticosteroids, minocycline, and recombinant hematopoietic growth factors), ethylene glycol intoxication, malignancy (carcinoma, melanoma, Hodgkin’s lymphoma, and sarcoma), and hemorrhage [ 1 , 4 ].…”

“…Leukemoid reaction (LR) is defined by a leukocyte count above 50 x 10 3 /µL with a predominance of mature neutrophils and the presence of immature granulocytic forms in the peripheral blood (left shift). It is caused by inflammatory reactions or organic stress with different etiologies: infections, drugs, intoxications, hemorrhage, and malignancy [ 1 ].…”