Hemophagocytic lymphohistiocytosis, a new cause of death during ‘post-acute COVID-19 syndrome?’ A case report

‘Post-acute coronavirus disease 2019 (COVID-19) syndrome’ is a new term that was coined to describe a constellation of persistent symptoms and new complications following recovery from COVID-19 initial illness. Identifying post-COVID-19 complications is crucial for early diagnosis and subsequent ini...

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Published inJournal of hematopathology Vol. 14; no. 3; pp. 229 - 233
Main Authors Naous, Elie, Nassani, Bertha-Maria, Yaghi, Cesar, Nasr, Fadi, Medlej, Rita
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2021
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Abstract ‘Post-acute coronavirus disease 2019 (COVID-19) syndrome’ is a new term that was coined to describe a constellation of persistent symptoms and new complications following recovery from COVID-19 initial illness. Identifying post-COVID-19 complications is crucial for early diagnosis and subsequent initiation of therapies to ensure more favorable outcomes. Severe COVID-19-related hemophagocytic lymphohistiocytosis (HLH) has been previously described during the acute phase of the infection. It is characterized by hyperinflammation, multi-organ involvement, and hemophagocytosis. We report the case of a 69-year-old woman who presented, two weeks after recovery from COVID-19, with hyperosmolar state and high inflammatory markers. Bone marrow aspirate, flow cytometry, extensive viral panel and total body scan were performed. Review of bone marrow aspirate smear showed hemophagocytosis. Flow cytometry, viral panel, and total body scan were normal. The diagnosis of post COVID-19-related HLH was made. Unfortunately, the patient died despite adequate treatment. To our knowledge, this is the first case establishing a high probability of COVID-19-related HLH given its occurrence two weeks following a documented biological and clinical recovery. Awareness and early recognition of HLH features following COVID-19 recovery should prompt timely initiation of therapy.
AbstractList ‘Post-acute coronavirus disease 2019 (COVID-19) syndrome’ is a new term that was coined to describe a constellation of persistent symptoms and new complications following recovery from COVID-19 initial illness. Identifying post-COVID-19 complications is crucial for early diagnosis and subsequent initiation of therapies to ensure more favorable outcomes. Severe COVID-19-related hemophagocytic lymphohistiocytosis (HLH) has been previously described during the acute phase of the infection. It is characterized by hyperinflammation, multi-organ involvement, and hemophagocytosis. We report the case of a 69-year-old woman who presented, two weeks after recovery from COVID-19, with hyperosmolar state and high inflammatory markers. Bone marrow aspirate, flow cytometry, extensive viral panel and total body scan were performed. Review of bone marrow aspirate smear showed hemophagocytosis. Flow cytometry, viral panel, and total body scan were normal. The diagnosis of post COVID-19-related HLH was made. Unfortunately, the patient died despite adequate treatment. To our knowledge, this is the first case establishing a high probability of COVID-19-related HLH given its occurrence two weeks following a documented biological and clinical recovery. Awareness and early recognition of HLH features following COVID-19 recovery should prompt timely initiation of therapy.
Author Yaghi, Cesar
Nasr, Fadi
Naous, Elie
Nassani, Bertha-Maria
Medlej, Rita
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Issue 3
Keywords COVID-19
Hemophagocytic lymphohistiocytosis
Post-acute Covid-19 syndrome
SARS-CoV-2
Hyperinflammatory syndrome
Late onset
Language English
License The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.
This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
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Snippet ‘Post-acute coronavirus disease 2019 (COVID-19) syndrome’ is a new term that was coined to describe a constellation of persistent symptoms and new...
'Post-acute coronavirus disease 2019 (COVID-19) syndrome' is a new term that was coined to describe a constellation of persistent symptoms and new...
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SubjectTerms Case Report
Hematology
Medicine
Medicine & Public Health
Pathology
Title Hemophagocytic lymphohistiocytosis, a new cause of death during ‘post-acute COVID-19 syndrome?’ A case report
URI https://link.springer.com/article/10.1007/s12308-021-00452-w
https://www.ncbi.nlm.nih.gov/pubmed/33897909
https://pubmed.ncbi.nlm.nih.gov/PMC8057656
Volume 14
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