Background In this report, we describe a very challenging case of a patient with secondary Evans syndrome caused by severe coronavirus disease 2019 infection in a pregnant full-term woman. Case presentation A 29-year-old full-term pregnant Indonesian woman presented with gross hematuria, dry cough, fever, dyspnea, nausea, anosmia, and fatigue 5 days after confirmation of coronavirus disease 2019 infection. Laboratory examinations showed very severe thrombocytopenia, increased indirect bilirubin, and a positive direct Coombs’ test. From peripheral blood, there was an increased number of spherocytes, which indicated an autoimmune hemolytic process. Antinuclear antibody and anti-double-stranded DNA test results were negative, and her virology serological markers are also negative for human immunodeficiency virus, cytomegalovirus, and hepatitis B and C. Despite aggressive treatment with platelet transfusion, high-dose steroid, and thrombopoietin receptor agonists, the platelet count did not recover, and a speculative cesarean delivery had to be done with a very low platelet count.
【저자키워드】 COVID-19, Evans syndrome, C-section delivery, 【초록키워드】 Treatment, coronavirus disease, fatigue, Infection, laboratory examination, Anosmia, Peripheral blood, DNA, Hematuria, Fever, Dyspnea, Patient, Platelet, hepatitis B, Autoimmune, receptor, Human immunodeficiency virus, pregnant, High-dose, antinuclear antibody, severe coronavirus disease, dry cough, syndrome, nausea, positive, agonists, caused, indicated, Coombs’ test, Evan, indirect bilirubin, serological marker, 【제목키워드】 Case report, Pregnant woman, severe coronavirus disease, syndrome, caused, Evan,