Clinical Signs and Treatment of New-Onset Bone Marrow Failure Associated SARS-CoV-2 Infection in Children: A Single Institution Prospective Cohort Study.

Autor:	Youssef MAM; Children Hospital, Hematology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt., Ahmed ES; Clinical Pathology Department-Faculty of Medicine-New Valley University., Kamal DT; Clinical Pathology Department - Faculty of Medicine-Assiut University., Elsayh KI; Children Hospital, Hematology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt., Abdelfattah MA; Children Hospital, Hematology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt., Mahran HH; Children Hospital, Hematology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt., Embaby MM; Children Hospital, Hematology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt.
Jazyk:	angličtina
Zdroj:	Mediterranean journal of hematology and infectious diseases [Mediterr J Hematol Infect Dis] 2024 Mar 01; Vol. 16 (1), pp. e2024034. Date of Electronic Publication: 2024 Mar 01 (Print Publication: 2024).
DOI:	10.4084/MJHID.2024.034
Abstrakt:	Background: Viral infections can cause direct and indirect damage to hematopoietic stem cells. The objectives of this study were to identify the frequency and severity of aplastic anemia in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as well as recognize the response to treatment. Methodology: 13 children with newly diagnosed severe aplastic anemia were enrolled in this prospective clinical trial. Blood samples were obtained from all patients to detect SARS-CoV-2 antibodies, and nasopharyngeal swabs were collected for reverse-transcription Polymerase Chain Reaction to detect SARS-CoV-2 viruses. According to the laboratory results, patients were classified as having SARS-CoV-2 positive antibodies and SARS-CoV-2 negative antibodies. Both groups received combined cyclosporine (CsA) + Eltrombopag (E-PAG). The hematological response, either complete response (CR) or partial response (PR), no response (NR), and overall response (OR) rates of combined E-PAG + CsA treatment after 6 months were evaluated. Results: Four children were recognized to have aplastic anemia and SARS-CoV-2 positive antibodies. Two patients fulfilled the hematological criteria for CR and no longer required transfusion of packed red blood cells (PRBCs) or platelets, and one had PR and was still PRBC transfusion-dependent but no longer required platelet transfusion. The remaining patient showed NR, and he had died before reaching the top of the HSCT waiting list. Moreover, six patients in the SARS-CoV-2 negative antibodies group had CR, while three patients had PR. The difference in ANC, Hg, and platelet counts between both groups was not significant. Conclusion: The SARS-CoV-2 virus is added to several viral infections known to be implicated in the pathogenesis of aplastic anemia. Studies are needed to establish a definitive association and determine whether the response of bone marrow failure to standard therapy differs from that of idiopathic cases. Competing Interests: Competing interests: The authors declare no conflict of Interest.
Databáze:	MEDLINE
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