SARS-CoV-2 and Autoimmune Cytopenia

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a variety of clinical manifestations related to viral tissue damage, as well as a virally induced immune response. Hyperstimulation of the immune system can serve as a trigger for autoimmunity. Several immune-mediated manifestations have been described in the course of SARS-CoV-2 infection. Immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA) are the most common hematologic autoimmune disorders seen in the course of SARS-CoV-2 infection. Vaccine-induced thrombocytopenia is a unique autoimmune hematologic cytopenia associated with SARS-CoV-2 vaccination. This paper will review the current literature on the association of SARS-CoV-2 infection and vaccination with autoimmune cytopenias and the clinical course of autoimmune cytopenias in patients with COVID-19.

Severe Thrombocytopenic Purpura Associated with COVID-19 in a Pediatric Patient

“… 28 The variable time delay between COVID-19 symptoms and the occurrence of ITP in some cases may call into question the causal nature of SARS-CoV-2 with ITP. 29 …”

First Case of Autoimmune Hemolytic Anemia Associated With COVID-19 Infection in Sri Lanka: A Case Report

“…The average age of presentation in adults was around 63 years [6] in literature whereas our patient was a young female, and the majority presented within the first two weeks of the onset of the symptoms of SARS-CoV-2 infection [6]. To the best of our knowledge, this is the third report showing a delayed onset of AIHA (twenty-fifth day from symptom onset).…”

“…According to Quinn and Murakhovskaya, around 31 cases have been reported as AIHA occurring during the acute SARS-CoV-2 infection. The majority of them were of warm AIHA (n=16) and the rest were found to be cold agglutinin syndrome (n=15) [6]. As evidenced by the Coombs test, IgG and complement became positive in eight out of 14 patients, IgA in one patient, and IgG alone in five patients [6].…”

“…The majority of them were of warm AIHA (n=16) and the rest were found to be cold agglutinin syndrome (n=15) [6]. As evidenced by the Coombs test, IgG and complement became positive in eight out of 14 patients, IgA in one patient, and IgG alone in five patients [6].…”

“…Autoimmune hemolytic anemia is a rare autoimmune disorder that could occur in association with several autoimmune, malignant, or infectious diseases such as human immunodeficiency virus, mycoplasma, hepatitis B, cytomegalovirus, and parvovirus [3,4]. Association with novel coronavirus is rare [5,6].…”