Severe Aplastic Anemia Secondary to SARS CoV-2 Infection- A Case Report

Author(s): Ranjima M, Gobbur RH

During the current COVID-19 pandemic, the assessment, and management of patients are challenging. The clinical features of COVID-19 are heterogeneous and subtle in many cases. Although Severe Acute Respiratory Syndrome Corona Virus 2 (SARS CoV-2) mainly affects pulmonary system, it has also been shown to cause abnormalities within the hematopoietic system by inducing neutropenia, lymphopenia, and in rare circumstances, central pancytopenia. Aplastic anemia is a potentially life-threatening acquired bone marrow failure syndrome which leads to central pancytopenia. The association between SARS CoV-2 and aplastic anemia is insufficiently explored in the current literature. Although the exact pathogenesis of the disorder is yet to be fully understood, it is thought to be primarily caused by post infective auto-immunity. Based on a clinical case of COVID-19 induced severe aplastic anemia and the available literature on virus induced aplastic anemia, we propose that the development of aplastic anemia in COVID-19 patients may be attributable to SARS CoV-2. We here report a case of a previously normal 4 years old child who developed severe aplastic anemia after being hospitalized for COVID-19.