Late-onset myocardial infarction and autoimmune haemolytic anaemia in a COVID-19 patient without respiratory symptoms, c
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CASE REPORT
Late‑onset myocardial infarction and autoimmune haemolytic anaemia in a COVID‑19 patient without respiratory symptoms, concomitant with a paradoxical increase in inflammatory markers: a case report Maria Chiara Pelle1* , Bruno Tassone1, Marco Ricchio1, Maria Mazzitelli1, Chiara Davoli1, Giada Procopio1, Anna Cancelliere1, Valentina La Gamba1, Elena Lio1, Giovanni Matera2, Angela Quirino2, Giorgio Settimo Barreca3, Enrico Maria Trecarichi1, Carlo Torti1 and IDTM UMG COVID-19 Group
Abstract Background: In December 2019, a new coronavirus (named severe acute respiratory syndrome coronavirus 2, SARSCoV-2) spread from China, causing a pandemic in a very short time. The main clinical presentation of SARS-CoV-2 infection (COVID-19, coronavirus disease-2019) is pneumonia, but several cardiovascular complications may also occur (e.g., acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure and cardiogenic shock). Direct or indirect mechanisms induced by SARS-CoV-2 could be implicated in the pathogenesis of these events. Case presentation: We report herein the third case of COVID-19 autoimmune haemolytic anaemia (AIHA) reported so far, which occurredwithout any other possible explanations in a Caucasian patient. The patient also suffered from ST-elevation myocardial injury. Conclusions: Both complications occurred quite late after COVID-19 diagnosis and were probably precipitated by systemic inflammation, as indicated by a significant delayed increase in inflammatory markers, including interleukin-6 (IL-6). Keywords: COVID-19, Inflammation, Cardiovascular disease, AIHA, Anaemia, IL-6 Background The main serious clinical presentation of COVID-19 is pneumonia, but several cardiovascular complications may also occur (e.g., acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure and cardiogenic shock) [1]. Moreover, there are few *Correspondence: [email protected] 1 Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy Full list of author information is available at the end of the article
studies describing AIHA during COVID-19 [2]. We report herein the third case of COVID-19 autoimmune haemolytic anaemia, which occurred after an ST-elevation myocardial injury in a patient without any respiratory symptoms.
Clinical case presentation An 86-year-old Caucasian woman suffering from hypertension and anxiety-depressive syndrome was admitted to our Infectious and Tropical Disease Unit on April 1st, 2020. She tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by nasopharyngeal
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