M403 COVID-19 IN A PATIENT WITH HYPER-EOSINOPHILIC SYNDROME TREATED WITH MEPOLIZUMAB

Abstract

Eosinophils constitute a small portion of circulating and tissue dwelling leukocytes, with its role in immunoregulation and antiviral activity still being elucidated. Diseases exist with eosinopenia and eosinophilia with varying susceptibility and outcomes related to certain viral infections. We present a case of a patient with GATA2 Haploinsufficiency and Hyper-Eosinophilic Syndrome on Mepolizumab who contracted the COVID19. Patient is a 22-year-old African American female with GATA2 haploinsufficiency, Hyper-Eosinophilic syndrome, hypercoagulability, Myelodysplasia who has a stable disease on Mepolizumab; an anti-IL 5 Humanized mAb (on GSK’s Nucala expanded access program since 2013). Patient presented to Emergency Department on 07/03/2020 with complaints of headache, nausea, and diffuse body aches without vomiting, diarrhea or fevers. A non-contrast CT head and Chest X-ray were negative for acute pathology, but SARS-COV2-PCR testing was positive. Absolute eosinophil count was 100 cells/microL on presentation. Patient was discharged home in stable condition. Telephone follow up 2 weeks later was done and patient reported complete resolution of symptoms without any complications or hospitalization. COVID-19 infection has multiple risk factors for complications, but anti-Eosinophilic therapy does not seem to be one. GATA2 deficiency, associated with invasive viral infections due NK cell deficit (1), does not appear to increase risk for COVID19 related complications. Patients treated with Mepolizumab, which decreases pulmonary eosinophils, does not put them at higher risk of viral infections (2,3). This case report, hopefully, adds to the evidence that anti-Eosinophilic biologic drugs can be safely used in patients during COVID-19 pandemic.