Henoch-Schönlein purpura: Another COVID-19 complication.

Whether affecting children or adults, SARS-CoV-2 infection (COVID-19) can have multi-organ involvement mediated by an inflammatory cascade. Immunoglobulin A (IgA) is one of the key components of the inflammatory cascade that can lead to endothelial injury and inflammation. IgA vasculitis or Henoch-Schönlein purpura (HSP) has been rarely reported in the context of COVID-19. In this report, we highlight a case of HSP occurring 2 days after diagnosis of COVID-19 in a 16-year-old boy, who presented with palpable purpura of the lower extremities and buttocks, diffuse abdominal pain, hemoptysis, and hematochezia. He was treated with oral prednisolone with rapid clinical improvement.

Should we screen Eastern Mediterranean COVID-19 patients for inherited thrombophilia?

The inflammatory component of Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) creates a pro-thrombotic state that necessitates a thrombophylactic strategy for hospitalized patients. Such strategies are difficult to be standardized because certain individuals can have pro-thrombotic conditions, such as inherited thrombophilia, which pre-dispose them to an additional coagulative risk. Whether outside the hospital or when admitted, patients with inherited thrombophilia need special anticoagulant and antiplatelet attention. Identifying such patients, especially in susceptible populations like the eastern Mediterranean (EM) region, will aid primary providers in risk stratification for choosing the optimal anticoagulation or antiplatelet plan.

Feline Coronavirus and Feline Infectious Peritonitis SARS-CoV-2 infection in patients with β-thalassemia: Experience from Lebanon

Summary While feline coronaviruses (FCoV) are ubiquitous in cat populations, the incidence of feline infectious peritonitis (FIP) remains low;nonetheless, the disease can be devastating for cat owners and shelter personnel. FIP is often challenging to diagnose, affects highly adoptable kittens and young cats, and creates prognostic uncertainty for healthy siblings of affected cats. FCoV is an enteric pathogen of cats that is often endemic in shelters and other multi-cat environments. Infection with FCoV generally occurs through fecal-oronasal transmission, most commonly through shared litterboxes contaminated with the virus. In some cases, more virulent strains of FCoV result in more severe FECV-related disease or an increased likelihood of mutation to FIPV. In others, the stress or immune status of the host plays a role in both decreased immune response and increased levels of shedding.

COVID-19, Antiphospholipid Antibodies, and Catastrophic Antiphospholipid Syndrome: A Possible Association?

Since the 2019 novel coronavirus (COVID-19) was first detected in December 2019, research on the complications and fatality of this virus has hastened. Initially, case reports drew an association between COVID-19 and abnormal coagulation parameters. Subsequently, cross-sectional studies found a high prevalence of thrombosis among ICU and non-ICU COVID-19 patients. For that reason, certain studies tried to explain the pathogenic mechanisms of thrombosis, one of which was the emergence of anti-phospholipid antibodies (aPL). Although aPL have been found positive in very few patients, their association with thrombotic events stays debatable. Given the thrombotic manifestations of COVID-19 and the potential role of aPL, the catastrophic form of APS (CAPS) might be a major fatal phenomenon. However, to date, there has been no clear association of CAPS to COVID-19. Moreover, since infections, including viral respiratory similar to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are considered main etiologies for CAPS, it could be possible that SARS-CoV-2 can induce CAPS although no evidence is currently found. High quality studies are needed to develop a clear idea on the pathogenic role of aPL in the progression of thrombosis in COVID-19 patients, and how such patients could be fit into a thromboprophylaxis plan.

COVID-19 in benign hematology: emerging challenges and special considerations for healthcare professionals.

INTRODUCTION: Many patients with inherited or acquired benign hematological disorders are at increased risk of developing severe complications from COVID-19. These patients, therefore, require specific advice regarding isolation and changes to their usual treatment schedules. Their disease can also be associated with significant burden, and they necessitate life-long and regular access to therapy, and regular follow-up consultations and hospital visits. The current COVID-19 pandemic is therefore presenting many challenges for these patients, their families, and health-care professionals. AREAS COVERED: This review provides an overview of the reported COVID-19 cases in the literature in patients with certain benign hematological disorders including thalassemia, sickle cell disease, hemophilia, immune thrombocytopenia, venous thromboembolism, and aplastic anemia. The review also outlines some recommendations on how to manage these patients if they are infected with SARS-CoV-2. To review the literature on benign hematological disorders and COVID-19, a bibliographic search was performed using PubMed for articles published between January 2020 and June 2020. EXPERT OPINION: International efforts must be made to continue reporting and better understanding the effects of SARS-CoV-2 infection in these patients and accordingly develop a set of recommendations to optimize the treatment of future infected patients.