Abstract
Impaired immune response with uncontrolled inflammation and various immunological disorders have been reported during SARS-CoV-2 infection. Here, we report a case of cold agglutinin disease occurring during a severe coronavirus disease 2019 (COVID-19) in a French intensive care unit. A patient was presented with acute respiratory distress syndrome, acute renal failure and haemolytic anaemia. Direct antiglobulin test was positive with a cold agglutinin titre of 1/512. No other cause than COVID-19 explained the occurrence of cold agglutinin disease; however, causality could not be formally established. Persistent anaemia despite transfusion therapy and the short-term life-threatening, prompted the infusion of a monoclonal anti-C5 antibody (eculizumab). Eculizumab therapy quasi-fully resolved haemolysis within a few days, but ultimately the patient died from his severe COVID-19 infection. Data regarding the specific treatment of cold agglutinin disease during COVID-19 are rare. Although additional studies are warranted, eculizumab may be considered in critical situations.
Keywords: Adult intensive care; COVID-19; Haematology (drugs and medicines); Infectious diseases.
【저자키워드】 COVID-19, Infectious diseases, adult intensive care, haematology (drugs and medicines), 【초록키워드】 Inflammation, immune response, therapy, Diseases, intensive care, antibody, SARS-COV-2 infection, eculizumab, Patient, Transfusion therapy, persistent, disease, Intensive, Critical, monoclonal, acute respiratory distress, acute renal failure, Severe COVID-19 Infection, Direct antiglobulin test, severe coronavirus disease, syndrome, life-threatening, titre, specific treatment, French, positive, Occurrence, died, reported, the patient, explained, resolved, Impaired, immunological disorder, 【제목키워드】 Cold agglutinin disease, severe SARS-CoV-2, treated,