COVID-19 Mimicking Hemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) Syndrome: A Case Report

Abstract

Background & aim: Hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP) was mimicked by several infectious conditions. It is critically important to distinguish these two, since their management and course differs, substantially.Case report: The case was a 27-year-old gravid patient with gestational age of 30 weeks who initially presented with headache and lower limb pain as well as leukopenia (and lymphopenia), normochromic normocytic anemia, thrombocytopenia, abnormal liver enzymes, increased lactate dehydrogenase enzyme and C-reactive protein. The patient was initially managed for HELLP syndrome, but due to the atypical presentation (low blood pressure and an episode of delirium when admitted), the novel coronavirus disease 2019 (COVID-19), real-time reverse transcription polymerase chain reaction (rRT-PCR) was requested for the patient that was positive. The spiral lung high-resolution computed tomography scan revealed changes compatible with COVID-19 diagnosis. Finally, the patient underwent uncomplicated normal vaginal delivery at 39th gestational week.Conclusion: It is important to consider the COVID-19 in differential diagnosis of patients suspected to HELLP syndrome, as the isolation and treatment of the patient is different and time-sensitive.