Abstract
BackgroundIn the recent COVID19 pandemic, patients with hematological disorders were considered at high risk for severe disease. Limited data is available regarding the course of COVID19 infection in this subgroup.Case PresentationWe describe a case of a 32-year-old man with paroxysmal nocturnal hemoglobinuria (PNH) undergoing treatment with ravulizumab (Ultomiris) who presented with COVID19 infection. He experienced only mild symptoms and had a rapid recovery from COVID19 infection.ConclusionThis case may demonstrate the beneficial effects of ravulizumab on complement mediated inflammatory damage linked with COVID19 infection especially in PNH patients.
Highlights
In the recent COVID19 pandemic, patients with hematological disorders were considered at high risk for severe disease
The clinical manifestation of COVID-19 is characterized by respiratory distress, and in more severe cases can progress towards acute respiratory distress syndrome (ARDS) and death [2]
The patient was treated with azithromycin, hydroxychloroquine, and prophylactic enoxaparin. He required no oxygen, remained afebrile, and oxygen saturation was maintained around 95 % in room air. He demonstrated a rapid and progressive improvement in his symptoms and was discharged from the Discussion and conclusions paroxysmal nocturnal hemoglobinuria (PNH) is a clonal disorder of hematopoietic progenitor cells caused by an acquired mutation of the X-linked phosphatidylinositol glycans class A (PIG-A) gene [9]
Summary
In the recent COVID19 pandemic, patients with hematological disorders were considered at high risk for severe disease. COVID-19 infection causes hyperactivation of the complement system and excessive inflammatory response leading to worsening lung injury and poor clinical outcomes [2, 5]. Complement blockade strategies are being prospectively studied in clinical trials and reported in case reports, no cases of PNH with COVID-19 infection managed with complement blocker agents have been reported [7, 8].
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