SARS-CoV-2 Infection in a patient with paroxysmal nocturnal haemoglobinuria (PNH) Treated with ravulizumab: a case report

Abstract

The clinical course of a Paroxysmal Nocturnal Hemoglobinuria (PNH) patient receiving treatment with terminal complement by ravulizumab and SARS-CoV2 infection is described. The treatment commenced in January 2016 showing adequate tolerance and symptom resolution. In April 2020 an episode of breakthrough hemolysis is observed. Chest X-Ray revealed a right infection lobar infiltrate with SARS-CoV-2 positive PCR. The patient was afebril with normal oxygen saturation. He did not require standard disease treatment and presented eventual resolution, developing only mild symptoms. Neither PNH nor ravulizumab treatment seem to influence susceptibility to Covid-19 infection. It is possible that razulizumab, a complement inhibitor, may have played a beneficial role in the favorable clinical development.