Vol 15 (2024): Continuous Publishing
Letter to the Editor
Published online: 2024-09-25
The treatment of COVID-19-related autoimmune haemolytic anaemia
1
DOI: 10.5603/hicp.97587
Hematology in Clinical Practice 2024;15(1):13-16.
Abstract
COVID-19-related autoimmune haemolytic anaemia (AIHA) has been reported since the onset of the pandemic. However, the precise aetiology is not fully understood and there is no consensus on the optimal treatment for COVID-19-related AIHA. To address this issue, we performed a literature review. Based on the available case reports, out of the 25 cases of COVID-19-related AIHA, 14 were diagnosed as warm AIHA and 11 as cold agglutinin disease (CAD). Thirteen out of the 14 warm AIHA cases were treated with steroids, while three were treated for CAD. Rituximab may be considered for use in steroid-refractory cases, with careful consideration of immunosuppression.
Keywords: COVID-19autoimmune haemolytic anaemia (AIHA)treatmentsteroid
References
- Taherifard E, Taherifard E, Movahed H, et al. Hematologic autoimmune disorders in the course of COVID-19: a systematic review of reported cases. Hematology. 2021; 26(1): 225–239.
- Angileri F, Légaré S, Marino Gammazza A, et al. Is molecular mimicry the culprit in the autoimmune haemolytic anaemia affecting patients with COVID-19? Br J Haematol. 2020; 190(2): e92–e93.
- AbouYabis AN, Bell GT. Hemolytic anemia complicating COVID-19 infection. J Hematol. 2021; 10(5): 221–227.
- Lazarian G, Quinquenel A, Bellal M, et al. Autoimmune haemolytic anaemia associated with COVID-19 infection. Br J Haematol. 2020; 190(1): 29–31.
- Patil NR, Herc ES, Girgis M. Cold agglutinin disease and autoimmune hemolytic anemia with pulmonary embolism as a presentation of COVID-19 infection. Hematol Oncol Stem Cell Ther. 2022; 15(4): 213–216.
- Capes A, Bailly S, Hantson P, et al. COVID-19 infection associated with autoimmune hemolytic anemia. Ann Hematol. 2020; 99(7): 1679–1680.
- Huscenot T, Galland J, Ouvrat M, et al. APHP Lariboisière COVID Group. SARS-CoV-2-associated cold agglutinin disease: a report of two cases. Ann Hematol. 2020; 99(8): 1943–1944.
- Maslov DV, Simenson V, Jain S, et al. COVID-19 and cold agglutinin hemolytic anemia. TH Open. 2020; 4(3): e175–e177.
- Jensen CE, Wilson S, Thombare A, et al. Cold agglutinin syndrome as a complication of COVID-19 in two cases. Clin Infect Pract. 2020; 7: 100041.
- Ramos-Ruperto L, García-Pérez E, Hernández-Maraver D, et al. A 3-case series of autoimmune haemolytic anaemia and COVID-19: Is plasma exchange an alternative? SN Compr Clin Med. 2021; 3(6): 1420–1423.
- Hindilerden F, Yonal-Hindilerden I, Akar E, et al. Severe autoimmune hemolytic anemia in COVID-19 infection, safely treated with steroids. Mediterr J Hematol Infect Dis. 2020; 12(1): e2020053.
- Jawed M, Hart E, Saeed M. Haemolytic anaemia: a consequence of COVID-19. BMJ Case Rep. 2020; 13(12).
- Jacobs J, Eichbaum Q. COVID-19 associated with severe autoimmune hemolytic anemia. Transfusion. 2021; 61(2): 635–640.
- Campos-Cabrera G, Mendez-Garcia E, Mora-Torres M, et al. Autoimmune hemolytic anemia as initial presentation of COVID-19 infection. Blood. 2020; 136(Supplement 1): 8–8.
- Hsieh TC, Sostin O. Severe warm autoimmune hemolytic anemia in COVID-19 managed with least incompatible RBC product and glucocorticoids. Ann Hematol. 2022; 101(2): 431–432.
- Liput JR, Jordan K, Patadia R, et al. Warm autoimmune hemolytic anemia associated with asymptomatic SARS-CoV-2 infection. Cureus. 2021; 13(3): e14101.
- Huda Z, Jahangir A, Sahra S, et al. A case of COVID-19-associated autoimmune hemolytic anemia with hyperferritinemia in an immunocompetent host. Cureus. 2021; 13(6): e16078.
- Horby P, Lim WS, Emberson JR, et al. RECOVERY Collaborative Group. Dexamethasone in hospitalized patients with COVID-19. N Engl J Med. 2021; 384(8): 693–704.
- Flores G, Cunningham-Rundles C, Newland AC, et al. Efficacy of intravenous immunoglobulin in the treatment of autoimmune hemolytic anemia: results in 73 patients. Am J Hematol. 1993; 44(4): 237–242.
- McLeod BC. Evidence based therapeutic apheresis in autoimmune and other hemolytic anemias. Curr Opin Hematol. 2007; 14(6): 647–654.
