COVID-19 in a Patient with Accidental Drug-Induced Neutropenia

  • Pascal B Meyre Department of Internal Medicine, Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Olten, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland
  • Milos Radosavac Department of Internal Medicine, Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Olten, Switzerland
  • Lukas Baumann Department of Internal Medicine, Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Olten, Switzerland
  • Rein Jan Piso Department of Internal Medicine, Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Olten, Switzerland
  • Matthias Hoffmann Department of Internal Medicine, Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Olten, Switzerland

Keywords

COVID-19, neutropenia, pneumectomy, clinical course

Abstract

Background: Coronavirus disease 2019 (COVID-19) presents with a wide range of illness severity, from asymptomatic disease to severe acute respiratory distress syndrome (ARDS). Immunosuppression is considered a risk factor for severe COVID-19, but there are only few reports on disease progression in immunocompromised patients. 
Case Summary: We report the case of a 50-year-old patient with acute COVID-19 pneumonia, who had iatrogenic, clinically relevant bone marrow suppression due to accidental overdose with hydroxyurea, and decreased lung capacity due to a left-sided pneumonectomy 6 months earlier. Symptomatic treatment with oxygen supplementation and pulmonary physical therapy was initiated, and hydroxyurea was discontinued. Over 14 days, the patient’s blood counts slowly recovered, and his clinical condition gradually improved, such that supplemental oxygen was no longer necessary and he could be discharged. 
Discussion: A gradual increase in neutrophil and lymphocyte counts may be preferable to dampen a potentially detrimental immunological response triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whether patients with severe COVID-19 benefit from immunosuppressive therapy should be further evaluated.

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Published: 2020-08-21

Issue: Vol 7 No 9 (view)

Section: Articles

How to cite:
1.
Meyre PB, Radosavac M, Baumann L, Piso RJ, Hoffmann M. COVID-19 in a Patient with Accidental Drug-Induced Neutropenia. EJCRIM [Internet]. 2020Aug.21 [cited 2020Oct.25];7(9). Available from: https://www.ejcrim.com/index.php/EJCRIM/article/view/1848