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

• Main Authors: Pascal B Meyre, Milos Radosavac, Lukas Baumann, Rein Jan Piso, Matthias Hoffmann
• Format: Article
• Language: English
• Published: SMC MEDIA SRL 2020-08-01
• Series: European Journal of Case Reports in Internal Medicine
• Subjects: covid-19; neutropenia; pneumectomy; clinical course
• Online Access: https://www.ejcrim.com/index.php/EJCRIM/article/view/1848

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.