Acute Non‐Immune Hemolytic Anemia Secondary to Coronavirus Disease 2019 Infection: A Pediatric Case Report

Background

The Coronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, has emerged as a global health crisis. While primarily known for its respiratory symptoms, COVID-19 can also manifest with a wide range of extrapulmonary complications, including hematological disorders.

Case report

This case involves an otherwise healthy 8-year-old child who was admitted to the hospital with symptoms of irritability, fatigue, and red-coloured urine lasting for one day. He was found to be hemodynamically stable, though laboratory tests revealed low hemoglobin levels with signs consistent with hemolysis. A COVID-19 PCR test returned positive. After ruling out immune-mediated causes of hemolysis, a diagnosis of non-immune hemolytic anemia associated with COVID-19 infection was established. The patient was successfully treated with a blood transfusion and supportive measures, leading to a complete recovery. This case highlights the potential for COVID-19 to trigger non-immune hemolytic anemia in pediatric patients.

Conclusion

Hemolytic anemia following COVID-19, as an extrapulmonary complication, can manifest as either immune-mediated or non-immune hemolysis. Both forms of Hemolytic anemia in COVID-19 have been observed to respond rapidly to symptomatic treatment, underscoring the significance of prompt therapeutic intervention in managing this rare hematologic complication.