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1.
J Pediatr Hematol Oncol ; 44(1): e134-e137, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1632085

ABSTRACT

To this day, there are limited data about the effects and management of coronavirus disease infection in pediatric patients with sickle cell disease. We present the management and successful clinical course of an 8-year-old female with homozygous sickle cell disease (SS) and severe acute chest syndrome secondary to coronavirus disease 2019 infection, complicated by cortical vein thrombosis.


Subject(s)
Anemia, Sickle Cell/complications , COVID-19/complications , Systemic Inflammatory Response Syndrome/complications , Anemia, Sickle Cell/pathology , Anemia, Sickle Cell/therapy , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , COVID-19/pathology , COVID-19/therapy , Ceftriaxone/therapeutic use , Child , Erythrocyte Transfusion , Female , Humans , Intensive Care Units , Systemic Inflammatory Response Syndrome/pathology , Systemic Inflammatory Response Syndrome/therapy
2.
Transfusion ; 61(11): 3267-3271, 2021 11.
Article in English | MEDLINE | ID: covidwho-1434847

ABSTRACT

BACKGROUND: Large clinical trials have demonstrated the overall safety of vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, reports have emerged of autoimmune phenomena, including vaccine-associated myocarditis, immune thrombocytopenia, and immune thrombotic thrombocytopenia. CASE PRESENTATION: Here we present a novel case of a young woman who developed life-threatening autoimmune hemolytic anemia (AIHA) after her first dose of a SARS-CoV-2 mRNA vaccine. Notably, initial direct antiglobulin testing was negative using standard anti-IgG reagents, which are "blind" to certain immunoglobulin (IgG) isotypes. Further testing using an antiglobulin reagent that detects all IgG isotypes was strongly positive and confirmed the diagnosis of AIHA. The patient required transfusion with 13 units of red blood cells, as well as treatment with corticosteroids, rituximab, mycophenolate mofetil, and immune globulin. CONCLUSION: As efforts to administer SARS-CoV-2 vaccines continue globally, clinicians must be aware of potential autoimmune sequelae of these therapies.


Subject(s)
Anemia, Hemolytic, Autoimmune/chemically induced , Anemia, Hemolytic, Autoimmune/therapy , COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , SARS-CoV-2 , Adrenal Cortex Hormones/administration & dosage , Adult , Anemia, Hemolytic, Autoimmune/blood , Autoantibodies/blood , COVID-19/blood , COVID-19 Vaccines/administration & dosage , Erythrocyte Transfusion , Female , Humans , Immunoglobulin G/blood , Immunoglobulins/administration & dosage , Mycophenolic Acid/administration & dosage , Rituximab/administration & dosage
4.
Blood Adv ; 5(12): 2586-2592, 2021 06 22.
Article in English | MEDLINE | ID: covidwho-1277907

ABSTRACT

The COVID-19 pandemic has created major disruptions in health care delivery, including a severe blood shortage. The inventory of Rh and K antigen-negative red cell units recommended for patients with hemoglobinopathies became alarmingly low and continues to be strained. Because patients with sickle cell disease requiring chronic red cell exchange (RCE) incur a large demand for red cell units, we hypothesized that implementation of 2 measures could reduce blood use. First, obtaining the pretransfusion hemoglobin S (HbS) results by procedure start time would facilitate calculation of exact red cell volume needed to achieve the desired post-RCE HbS. Second, as a short-term conservation method, we identified patients for whom increasing the targeted end procedure hematocrit up to 5 percentage points higher than the pretransfusion level (no higher than 36%) was not medically contraindicated. The goal was to enhance suppression of endogenous erythropoiesis and thereby reduce the red cell unit number needed to maintain the same target HbS%. These 2 measures resulted in an 18% reduction of red cell units transfused to 50 patients undergoing chronic RCE during the first 6 months of the COVID-19 pandemic. Despite reduction of blood use, pretransfusion HbS% target goals were maintained and net iron accumulation was low. Both strategies can help alleviate a shortage of Rh and K antigen-negative red cells, and, more generally, transfusing red cell units based on precise red cell volume required can optimize patient care and judicious use of blood resources.


Subject(s)
Anemia, Sickle Cell , COVID-19 , Anemia, Sickle Cell/therapy , Erythrocyte Transfusion , Humans , Pandemics , SARS-CoV-2
5.
J Pediatr Hematol Oncol ; 44(1): e134-e137, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1232239

ABSTRACT

To this day, there are limited data about the effects and management of coronavirus disease infection in pediatric patients with sickle cell disease. We present the management and successful clinical course of an 8-year-old female with homozygous sickle cell disease (SS) and severe acute chest syndrome secondary to coronavirus disease 2019 infection, complicated by cortical vein thrombosis.


Subject(s)
Anemia, Sickle Cell/complications , COVID-19/complications , Systemic Inflammatory Response Syndrome/complications , Anemia, Sickle Cell/pathology , Anemia, Sickle Cell/therapy , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , COVID-19/pathology , COVID-19/therapy , Ceftriaxone/therapeutic use , Child , Erythrocyte Transfusion , Female , Humans , Intensive Care Units , Systemic Inflammatory Response Syndrome/pathology , Systemic Inflammatory Response Syndrome/therapy
6.
Transfus Apher Sci ; 60(4): 103129, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1195468

ABSTRACT

Call back as a procedure to report post donation symptoms or illness by donors has been established since 2009 in Iranian Blood Transfusion Organization (IBTO). During the first phase of COVID-19 outbreak, all blood donors were requested to report any respiratory infection symptoms after donation. The study investigated the callback data of COVID-19 in Tehran Blood Center during the first 3 months of the outbreak in Iran. The purpose of this study was to estimate the frequency of post donation COVID-19 related call back reports and determine its implications for blood donors and patients. A telephone interview was conducted with donors who had reported COVID-19 symptoms. Some questions were asked to evaluate donor's health at the time of blood donation. The donors categorized into three groups: laboratory-confirmed, suspected, and COVID-19 irrelevant based on their answers. In cases that the blood component obtained from a laboratory-confirmed donor had been released, the hospital was notified and asked to follow up the recipient for COVID-19. The results showed 30 donors (0.08 %) had callback related to COVID-19 and 76.63 % of the obtained component was disposed. The results also showed that only one donor had a laboratory-confirmed result with the RBC unit processed from her whole blood released for transfusion. The RBC unit recipient did not show any signs or symptoms of infection during a 46-day follow-up. Concluded that callback system was effective to remove most of the components obtained from the donors who reported to be COVID-19 suspected or confirmed. Moreover, the result did not support virus transmission through blood transfusion.


Subject(s)
Blood Donors , Blood Safety , Blood-Borne Infections/prevention & control , COVID-19/prevention & control , Donor Selection , Pandemics , SARS-CoV-2 , Transfusion Reaction/prevention & control , Adult , Aged , Blood Component Transfusion/adverse effects , Blood Component Transfusion/statistics & numerical data , COVID-19/blood , COVID-19/diagnosis , COVID-19/transmission , COVID-19 Nucleic Acid Testing , Erythrocyte Transfusion/adverse effects , Female , Follow-Up Studies , Humans , Infant, Newborn , Interviews as Topic , Iran/epidemiology , Male , Middle Aged , Pulmonary Valve Stenosis/surgery , Symptom Assessment , Young Adult
9.
PLoS One ; 16(3): e0247282, 2021.
Article in English | MEDLINE | ID: covidwho-1127785

ABSTRACT

Intra-operative autologous blood donation is a blood conservation technique with limited evidence. We evaluated the association between intra-operative autologous blood donation and decrease in peri-operative transfusion in cardiovascular surgery based on evidence from a Japanese administrative database. We extracted the data of patients who had undergone cardiovascular surgery from the Diagnosis Procedure Combination database in Japan (2016-2019). Based on the surgery type, we examined the association of intra-operative autologous blood donation with the transfusion rate and amount of blood used in cardiac and aortic surgeries using multilevel propensity score matching. We enrolled 32,433 and 4,267 patients who underwent cardiac and aortic surgeries and received 5.0% and 6.7% intra-operative autologous blood donation with mean volumes of 557.68 mL and 616.96 mL, respectively. The red blood cell transfusion rates of the control and intra-operative autologous blood donation groups were 60.6% and 38.4%, respectively, in the cardiac surgery cohort (p < .001) and 91.4%, and 83.8%, respectively, in the aortic surgery cohort (p = .037). The transfusion amounts for the control and intra-operative autologous blood donation groups were 5.9 and 3.5 units of red blood cells, respectively, for cardiac surgery patients (p < .001) and 11.9 and 7.9 units, respectively, for aortic surgery patients (p < .001). Intra-operative autologous blood donation could reduce the transfusion rate or amount of red blood cells and fresh frozen plasma for patients undergoing index cardiovascular surgery and could be an effective blood transfusion strategy in cardiovascular surgery for Japanese patients.


Subject(s)
Blood Donors/statistics & numerical data , Blood Transfusion, Autologous/statistics & numerical data , Cardiovascular Diseases/surgery , Adult , Aged , Aged, 80 and over , Erythrocyte Transfusion , Female , Humans , Intraoperative Care , Japan , Male , Middle Aged , Multilevel Analysis , Propensity Score , Retrospective Studies , Young Adult
10.
J Med Case Rep ; 15(1): 104, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1112451

ABSTRACT

BACKGROUND: Pregnancy seems to increase the risk of thrombotic thrombocytopenic purpura (TTP) relapses and make the TTP more severe in any of the pregnancy trimesters, or even during the postpartum period. CASE PRESENTATION: This study highlights details of treating a COVID-19 pregnant patient who survived. This 21-year addicted White woman was admitted at her 29th week and delivered a stillbirth. She was transferred to another hospital after showing signs of TTP, which was caused by a viral infection. CONCLUSION: This viral infection caused fever and dyspnea, and the patient was tested positive for COVID-19 infection. A chest computed tomography scan showed diffuse multiple bilateral consolidations and interlobar septal thickening. She stayed at the Intensive Care Unit for 20 days and treated with plasmapheresis. As far as we know, this is the first report of a TTP pregnant patient with COVID-19 infection.


Subject(s)
COVID-19/diagnosis , Plasmapheresis , Pregnancy Complications, Hematologic/diagnosis , Pregnancy Complications, Infectious/diagnosis , Purpura, Thrombotic Thrombocytopenic/diagnosis , Stillbirth , Acute Kidney Injury/therapy , Amphetamine-Related Disorders , Antiviral Agents/therapeutic use , COVID-19/therapy , Drug Combinations , Erythrocyte Transfusion , Female , Hemoglobins/metabolism , Humans , Hydroxychloroquine/therapeutic use , Intensive Care Units , L-Lactate Dehydrogenase/metabolism , Lopinavir/therapeutic use , Methamphetamine , Pregnancy , Pregnancy Complications, Hematologic/metabolism , Pregnancy Complications, Hematologic/therapy , Pregnancy Complications, Infectious/metabolism , Pregnancy Complications, Infectious/therapy , Purpura, Thrombotic Thrombocytopenic/metabolism , Purpura, Thrombotic Thrombocytopenic/therapy , Renal Dialysis , Ritonavir/therapeutic use , SARS-CoV-2 , Tomography, X-Ray Computed , Young Adult
14.
Blood Coagul Fibrinolysis ; 32(4): 294-297, 2021 Jun 01.
Article in English | MEDLINE | ID: covidwho-1066464

ABSTRACT

Factor V inhibitors are a rare cause of life-threatening bleeding. We present a case of an acquired factor V inhibitor likely caused by coronavirus disease 2019 infection. Bleeding was manifested by severe anemia requiring frequent red-cell transfusion, left psoas muscle hematoma, and left retroperitoneal cavity hematoma. Factor V activity was less than 1% and the factor V inhibitor titer was 31.6 Bethesda units. Severe acute respiratory syndrome coronavirus 2 RNA testing of the nasopharynx was positive 2 weeks before presentation and continued to be positive for 30 days. The patient failed treatment with intravenous immunoglobulin and dexamethasone. Three cycles of plasmapheresis with fresh frozen plasma replacement resulted in correction of the bleeding and laboratory coagulopathy. This is the first reported case of a factor V inhibitor in a coronavirus disease 2019 patient and suggests that plasmapheresis may be a successful treatment strategy.


Subject(s)
Autoantibodies/biosynthesis , COVID-19/blood , Factor V/immunology , Hemorrhagic Disorders/etiology , SARS-CoV-2 , Aged, 80 and over , Anemia/etiology , Anemia/therapy , Antibodies, Viral/blood , Antibody Specificity , Autoantibodies/immunology , COVID-19/complications , COVID-19/diagnosis , COVID-19/immunology , Combined Modality Therapy , Comorbidity , Delayed Diagnosis , Dexamethasone/therapeutic use , Erythrocyte Transfusion , Factor V/antagonists & inhibitors , Female , Hematoma/etiology , Hemorrhagic Disorders/drug therapy , Hemorrhagic Disorders/therapy , Humans , Immunoglobulins, Intravenous/therapeutic use , Lupus Coagulation Inhibitor/blood , Octreotide/therapeutic use , Plasma , Plasmapheresis , SARS-CoV-2/immunology , Vitamin K/therapeutic use
15.
A A Pract ; 14(9): e01287, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-992616

ABSTRACT

Methemoglobinemia is a rare disorder of the blood in which there is an increase in methemoglobin, which occurs when hemoglobin is present in the oxidized form. Methemoglobin impairs hemoglobin's ability to transport oxygen, produces functional anemia, and leads to tissue hypoxia. We report the successful management of a case of refractory hypoxia due to acutely acquired methemoglobinemia in a patient undergoing treatment for coronavirus disease 2019 (COVID-19) pneumonia. The cause of methemoglobinemia in this patient remains unknown. Hypoxia and methemoglobinemia did not respond to methylene blue and required administration of packed red blood cell transfusions.


Subject(s)
Coronavirus Infections/complications , Hypoxia/etiology , Methemoglobinemia/complications , Pneumonia, Viral/complications , Respiratory Insufficiency/etiology , Acute Kidney Injury/complications , Acute Kidney Injury/therapy , Aged , Antibodies, Monoclonal, Humanized/therapeutic use , Antioxidants/therapeutic use , Ascorbic Acid/therapeutic use , Betacoronavirus , COVID-19 , Coronavirus Infections/drug therapy , Corynebacterium , Corynebacterium Infections/complications , Corynebacterium Infections/therapy , Cytokine Release Syndrome/complications , Enzyme Inhibitors/therapeutic use , Erythrocyte Transfusion , Hematinics/therapeutic use , Humans , Hydroxocobalamin/therapeutic use , Hydroxychloroquine/therapeutic use , Hypoxia/therapy , Male , Methemoglobinemia/therapy , Methylene Blue/therapeutic use , Pandemics , Pneumonia, Bacterial/complications , Pneumonia, Bacterial/therapy , Pneumonia, Viral/drug therapy , Renal Replacement Therapy , Respiratory Insufficiency/therapy , SARS-CoV-2 , Shock, Septic/complications
17.
Perm J ; 242020.
Article in English | MEDLINE | ID: covidwho-922950

ABSTRACT

INTRODUCTION: The growing coronavirus disease 2019 (COVID-19) pandemic initially led to widespread use of hydroxychloroquine sulfate as an off-label experimental treatment of this disease. CASE PRESENTATION: Acute hemolytic anemia developed in an African American man with COVID-19-related pneumonia and glucose-6-phosphate dehydrogenase (G6PD) deficiency who completed the standard 5-day experimental course of hydroxychloroquine. Although the trigger leading to our patient's hemolytic sequelae will never be known with certainty, his clinical course suggests that hydroxychloroquine use and/or COVID-19 infection may trigger hemolysis in susceptible patients with G6PD deficiency. DISCUSSION: This case confirms recent findings that the potential risks of hydroxychloroquine therapy for COVID-19 may outweigh the benefits.


Subject(s)
Anemia, Hemolytic/complications , COVID-19/complications , Enzyme Inhibitors/therapeutic use , Glucosephosphate Dehydrogenase Deficiency/complications , Hydroxychloroquine/therapeutic use , Anemia, Hemolytic/therapy , COVID-19/drug therapy , Enzyme Inhibitors/adverse effects , Erythrocyte Transfusion , Humans , Hydroxychloroquine/adverse effects , Male , Middle Aged
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