ABSTRACT
BackgroundAfter each peak of COVID-19 pandemic, an increase in post-COVID syndromes and long COVID-19 symptoms can be observed. Henoch-Schönlein purpura is an IgA-related vasculopathy involving small vessels, mostly in children.Case presentationthe first case was a 15-year-old boy who afflicted COVID-19 and after a while, he developed lower limb weakness, limping, abdominal pain, and proteinuria. In his kidney biopsy mesangioproliferation and IgA deposition in the mesangium were seen. The second case was a 15-year -old girl known case of Henoch-Schönlein purpura who experienced proteinuria and hematuria 10 days after COVID-19 affliction. In her kidney biopsy IgA deposition and hypercellular mesangium were found in favor of Henoch-Schönlein purpura flare up.ConclusionIt is postulated that COVID-19 can induce the first HSP flare up. It can also trigger HSP flare ups in patients with positive history of Henoch-Schoenlein Purpura.
Subject(s)
COVID-19ABSTRACT
Purpose: This study aimed to assess the effect of COVID-19 on patients with IEIs, the potentially at-risk population, regarding the clinical course, complications, severity, and outcomes. Methods This two-phase study was conducted on patients from three referral immunodeficiency centers in Iran. At phase one, 98 IEI patients with COVID-19 infection were evaluated by telephone follow-up (TFU). At phase two, the demographic, clinical, and laboratory records of clinically confirmed 33 IEI patients with COVID-19 infection were collected and analyzed. Results At phase one, 16.3% represented COVID-19 infection without any report of pediatric intensive care unit (PICU) admission or death. During the second phase, combined immunodeficiency (CID) (42.4%) and predominantly antibody deficiencies (PADs) (33.3%) were the predominant immune defects. Atopy (27.3%) and lung disorders (27.3%) were the frequent pre-existing comorbidities. Organomegaly (p=0.030) and renal disorders ( p=0.033 ) were significantly associated with the development of respiratory insufficiency. Cyanosis, tachypnea, intercostal retraction, and seizure were the chief complaints of patients who were more likely to progress respiratory insufficiency (p<0.05) , being admitted to the PICU (p<0.05) , and/or deceased (p<0.05) . Laboratory evaluation revealed a marked positive correlation between D-Dimer ( p=0.045 ), prothrombin time ( p=0.045 ), C-reactive protein ( p=0.041 ), proteinuria ( p=0.013 ), ferritin ( p=0.020 ), metabolic acidosis ( p=0.003 ), and troponin ( p=0.049 ) level with mortality. We detected a significant association between the chest X-ray pattern of COVID-19 infection with PICU admission (p=0.023) and death (p=0.046) . Conclusion In the current study, patients with CID and PAD were introduced as patients at high risk of COVID-19 infection, who may need extra protective and therapeutic measurements.