ABSTRACT
Introduction Management of newly diagnosed acute myeloid leukemia (AML) together with severe coronavirus disease 2019 (COVID-19) is challenging;moreover, the optimal treatment is unknown. Patients with leukemia might be at a higher risk of developing COVID-19 because of associated myelosuppression in the case of AML. The authors present the management of a confirmed case of severe COVID-19 in a newly diagnosed patients with acute promyelocytic leukemia (APL) and review of the literature. Case A 33-year-old man got referred to the hematology outpatient clinic because of marked leukocytosis and moderate thrombocytopenia. He was diagnosed as having COVID-19 pneumonia and high-risk APL at the same time. AIDA protocol and COVID-19 pneumonia treatments had to be given at the same time. At the end of this successful treatment process, the patient was discharged with complete remission. Discussion APL is a distinct and rare type of AML. Coagulopathy is the most important cause of early death owing to APL. Although there is no consensus regarding the treatment approach to be applied in the co-existence of AML and COVID-19 infection, there are various recommendations. Conclusion The simultaneous diagnosis of high-risk APL and covid-19 is a challenging process for both patients and clinicians. (C) 2022 The Egyptian Journal of Haematology
ABSTRACT
Background: The data related to the neurologic manifestations of coronavirus disease 2019 (COVID-19) in children are limited. The frequency of the neurologic manifestations and the risk factors in the development of these symptoms are not clear. Objectives: We aimed to determine the exact frequency of the neurological symptoms in pediatric patients with confirmed COVID-19 and to identify the risk factors for the development of neurological manifestations. Materials and Methods: We included pediatric Covid-19 patients admitted to the Children's Hospital of Ankara City Hospital between March 22 and June 1, 2020. Neurological findings were questioned by interviewing the patients and their families and detailed neurologic examinations were performed within protection measures. Results: A total of 312 pediatric patients with the diagnosis of COVID-19 were enrolled in the study. Sixty-six participants (21.15%) showed neurologic symptoms during COVID-19. Headache was the most common neurologic symptom and present in 14% (n: 44) of the cases. The other neurologic symptoms were myalgia (n: 30, 9.6%), anosmia/hyposmia (n: 6, 1.9%), ageusia (n: 2, 0.6%), and vertigo (n: 1, 0.3%). Neutrophil-to-lymphocyte ratio (NLR) (P = 0.002) and platelet-to-lymphocyte ratio (PLR) (P = 0.001) were significantly elevated in patients with neurological symptoms when compared to the patients without the symptoms. Conclusions: Physicians should be alert to the neurologic involvement of COVID-19 disease in children. NLR and PLR ratios could have a predictive value for the development of neurological manifestations.