COVID‑19 infection and severe autoimmune haemolytic anaemia: A case report and review of the literature

During the ongoing coronavirus disease 2019 (COVID-19) pandemic, a number of autoimmune diseases have been found to be associated with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection, with thrombocytopenia being the most common. The present study describes the case of a female patient who tested positive for SARS-CoV-2 infection from samples from two nasopharyngeal swabs examined using RT-PCR; she was admitted to hospital for severe anaemia. The woman also tested positive to direct antiglobulin test (DAT). In addition, the literature was reviewed for cases of anaemia concomitant to COVID-19 and only cases of autoimmune haemolytic anaemia (AIHA) with positive DAT were considered. A total of 38 cases of AIHA concomitant to COVID-19 were identified. In the cases reported in the literature, both warm AIHA and cold agglutinin disease were observed, with a marked prevalence of CAD. The majority of the cases identified in the literature, including the patient described herein, have had a full recovery from both COVID-19 and AIHA; however, as some of the patients visited the hospital for observation when their condition was already at an advanced and severe stage, effective therapy could not be administered and they consequently succumbed. On the whole, as autoimmune anaemia may be a consequence of SARS-CoV-2 infection, it should perhaps be considered among the haematological autoimmune disorders secondary to COVID-19, along with thrombocytopenia.