A Case of Neutropenia Associated with COVID-19

Abstract

SARS-CoV2 is a novel respiratory viral illness responsible for a global pandemic that started in the late 2019. Signs and symptoms being non-specific, clinicians relied on a constellation of abnormal results obtained from clinical investigations and imaging to diagnose the illness prior to the availability of widespread, timely testing. One proposed metric was the increased neutrophil to lymphocyte ratio (NLR) observed in patients suffering from COVID-19. Those with higher ratios were generally admitted to the Intensive Care Unit (ICU) with detrimental outcomes. Neutrophilia and lymphocytopenia were common occurrences in COVID-19 cases worldwide, even among those not severe enough to be in ICU. Here, we present a case of a 41-year-old SARS-CoV2 positive male who initially presented with fever, but then developed neutropenia. It is unknown whether his decreased neutrophil count was attributable current medications, an additional underlying infection, or whether it was due to the virus itself. Review of the literature did not yield any similar cases. Learning Points Prior clinical cases have shown that COVID positive patients present with an increased neutrophil to lymphocyte ratio (NLR) where a higher NLR correlates to increased clinical severity; however, our case highlights a case of neutropenia in a covid-19 patient.