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Hemophagocytic syndrome secondary to SARS-Cov-2 infection: a case report

Marco Meazza Prina1, Francesca Martini2, Federico Bracchi1

  • 1Department of Internal Medicine and Onco-Haematology Policlinico S.Marco, GSD University and Research Hospital, Corso Europa 7, 24040, Zingonia, BG, Italy.

BMC Infectious Diseases
|August 14, 2021
PubMed

Insights

Severe hyperinflammatory disease, hemophagocytic syndrome (HPS), can develop after mild COVID-19. This case highlights HPS secondary to Sars-CoV-2 infection, even after recovery, and suggests a treatment approach.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Hematology

Background:

  • Hemophagocytic syndrome (HPS) is a critical hyperinflammatory condition diagnosed via HLH-2004 criteria.
  • Secondary HPS (sHLH) management focuses on treating triggers like COVID-19.
  • The association between COVID-19 cytokine storms and sHLH is known, but post-recovery manifestations remain unclear.

Observation:

  • A case report details a woman with sHLH following a prior Sars-CoV-2 infection.
  • The patient experienced mild or asymptomatic COVID-19 symptoms.

Findings:

  • The case suggests HPS can be secondary to Sars-CoV-2 infection, even after apparent viral clearance.
  • Treatment involved steroids, colchicine, etoposide, and ruxolitinib.

Implications:

  • This case indicates that HLH-like syndromes may arise post-Sars-CoV-2 infection, irrespective of initial symptom severity.
  • Low-dose ruxolitinib combined with etoposide presents a potential therapeutic strategy for Sars-CoV-2-related HLH.
Abstract

Keywords:
COVID-19Case reportHemophagocytic syndromePolyserositis

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