Skip to main content
Top
Published in: Thrombosis Journal 1/2021

Open Access 01-12-2021 | Aplastic Anemia | Case report

COVID19 infection in a patient undergoing treatment for Paroxysmal Nocturnal Hemoglobinuria (PNH) with Ravulizumab

Authors: Sufana Shikdar, Azra Borogovac, Elabdallah Mohamad, Mohamad Khawandanah

Published in: Thrombosis Journal | Issue 1/2021

Login to get access

Abstract

Background

In the recent COVID19 pandemic, patients with hematological disorders were considered at high risk for severe disease. Limited data is available regarding the course of COVID19 infection in this subgroup.

Case Presentation

We describe a case of a 32-year-old man with paroxysmal nocturnal hemoglobinuria (PNH) undergoing treatment with ravulizumab (Ultomiris) who presented with COVID19 infection. He experienced only mild symptoms and had a rapid recovery from COVID19 infection.

Conclusion

This case may demonstrate the beneficial effects of ravulizumab on complement mediated inflammatory damage linked with COVID19 infection especially in PNH patients.
Literature
2.
go back to reference Bosmann M. Complement activation during critical illness: Current findings and an outlook in the era of COVID-19. Am J Respir Crit Care Med. 2020;202:163–5.CrossRef Bosmann M. Complement activation during critical illness: Current findings and an outlook in the era of COVID-19. Am J Respir Crit Care Med. 2020;202:163–5.CrossRef
3.
go back to reference Najjar S, Najjar A, Chong DJ, Pramanik BK, Kirsch C, Kuzniecky RI, et al. Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of pathophysiology and case reports. J Neuroinflammation. 2020;17:231.CrossRef Najjar S, Najjar A, Chong DJ, Pramanik BK, Kirsch C, Kuzniecky RI, et al. Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of pathophysiology and case reports. J Neuroinflammation. 2020;17:231.CrossRef
4.
go back to reference Aleem A, AB AS, Slenker AK. Emerging Variants of SARS-CoV-2 And Novel Therapeutics Against Coronavirus (COVID-19). Aleem A, AB AS, Slenker AK. Emerging Variants of SARS-CoV-2 And Novel Therapeutics Against Coronavirus (COVID-19).
5.
go back to reference Fletcher-Sandersjöö A, Bellander B-M. Is COVID-19 associated thrombosis caused by overactivation of the complement cascade? A literature review. Thromb Res. 2020;194:36–41.CrossRef Fletcher-Sandersjöö A, Bellander B-M. Is COVID-19 associated thrombosis caused by overactivation of the complement cascade? A literature review. Thromb Res. 2020;194:36–41.CrossRef
7.
go back to reference Mastaglio S, Ruggeri A, Risitano AM, Angelillo P, Yancopoulou D, Mastellos DC, et al. The first case of COVID-19 treated with the complement C3 inhibitor AMY-101. Clin Immunol. 2020;215:108450.CrossRef Mastaglio S, Ruggeri A, Risitano AM, Angelillo P, Yancopoulou D, Mastellos DC, et al. The first case of COVID-19 treated with the complement C3 inhibitor AMY-101. Clin Immunol. 2020;215:108450.CrossRef
8.
go back to reference Vlaar A.Open-label. Randomized Study of IFX-1 in Patients With Severe COVID-19 Pneumonia (PANAMO) 2020. [accessed 2020 July ]Available from: https://clinicaltrialsgov/ct2/show/NCT04333420 [Ref list]. Vlaar A.Open-label. Randomized Study of IFX-1 in Patients With Severe COVID-19 Pneumonia (PANAMO) 2020. [accessed 2020 July ]Available from: https://​clinicaltrialsgo​v/​ct2/​show/​NCT04333420 [Ref list].
9.
go back to reference Rosti V. The molecular basis of paroxysmal nocturnal hemoglobinuria. Haematologica. 2000;85:82–7.PubMed Rosti V. The molecular basis of paroxysmal nocturnal hemoglobinuria. Haematologica. 2000;85:82–7.PubMed
10.
go back to reference Gembillo G, Siligato R, Cernaro V, Santoro D. Complement inhibition therapy and dialytic strategies in paroxysmal nocturnal hemoglobinuria: The nephrologist’s opinion. J Clin Med. 2020;9:1261.CrossRef Gembillo G, Siligato R, Cernaro V, Santoro D. Complement inhibition therapy and dialytic strategies in paroxysmal nocturnal hemoglobinuria: The nephrologist’s opinion. J Clin Med. 2020;9:1261.CrossRef
12.
go back to reference Stern RM, Connell NT. Ravulizumab: a novel C5 inhibitor for the treatment of paroxysmal nocturnal hemoglobinuria. Ther Adv Hematol. 2019;10:2040620719874728.CrossRef Stern RM, Connell NT. Ravulizumab: a novel C5 inhibitor for the treatment of paroxysmal nocturnal hemoglobinuria. Ther Adv Hematol. 2019;10:2040620719874728.CrossRef
13.
go back to reference Porfidia A, Valeriani E, Pola R, Porreca E, Rutjes AWS, Di Nisio M. Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis. Thromb Res. 2020;196:67–74.CrossRef Porfidia A, Valeriani E, Pola R, Porreca E, Rutjes AWS, Di Nisio M. Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis. Thromb Res. 2020;196:67–74.CrossRef
14.
go back to reference Risitano AM, Mastellos DC, Huber-Lang M, Yancopoulou D, Garlanda C, Ciceri F, et al. Complement as a target in COVID-19? Nat Rev Immunol. 2020;20:343–4.CrossRef Risitano AM, Mastellos DC, Huber-Lang M, Yancopoulou D, Garlanda C, Ciceri F, et al. Complement as a target in COVID-19? Nat Rev Immunol. 2020;20:343–4.CrossRef
16.
go back to reference McEneny-King AC, Monteleone JP, Kazani SD, Ortiz SR. Pharmacokinetic and pharmacodynamic evaluation of ravulizumab in adults with severe Coronavirus Disease 2019. Infectious Diseases Therapy. 2021 ;10(2):1045–54.CrossRef McEneny-King AC, Monteleone JP, Kazani SD, Ortiz SR. Pharmacokinetic and pharmacodynamic evaluation of ravulizumab in adults with severe Coronavirus Disease 2019. Infectious Diseases Therapy. 2021 ;10(2):1045–54.CrossRef
18.
go back to reference Annane D, Heming N, Grimaldi-Bensouda L, Frémeaux-Bacchi V, Vigan M, Roux AL, Marchal A, Michelon H, Rottman M, Moine P. Eculizumab as an emergency treatment for adult patients with severe COVID-19 in the intensive care unit: a proof-of-concept study. EClinicalMedicine. 2020 Nov 1;28:100590. Annane D, Heming N, Grimaldi-Bensouda L, Frémeaux-Bacchi V, Vigan M, Roux AL, Marchal A, Michelon H, Rottman M, Moine P. Eculizumab as an emergency treatment for adult patients with severe COVID-19 in the intensive care unit: a proof-of-concept study. EClinicalMedicine. 2020 Nov 1;28:100590.
19.
go back to reference Wilkinson T, Dixon R, Page C, Carroll M, Griffiths G, Ho LP, De Soyza A, Felton T, Lewis KE, Phekoo K, Chalmers JD. ACCORD: a multicentre, seamless, phase 2 adaptive randomisation platform study to assess the efficacy and safety of multiple candidate agents for the treatment of COVID-19 in hospitalised patients: a structured summary of a study protocol for a randomised controlled trial. Trials. 2020 ;21(1):1–3.CrossRef Wilkinson T, Dixon R, Page C, Carroll M, Griffiths G, Ho LP, De Soyza A, Felton T, Lewis KE, Phekoo K, Chalmers JD. ACCORD: a multicentre, seamless, phase 2 adaptive randomisation platform study to assess the efficacy and safety of multiple candidate agents for the treatment of COVID-19 in hospitalised patients: a structured summary of a study protocol for a randomised controlled trial. Trials. 2020 ;21(1):1–3.CrossRef
20.
go back to reference Kulkarni S, Fisk M, Kostapanos M, Banham-Hall E, Bond S, Hernan-Sancho E, Norton S, Cheriyan J, Cope A, Galloway J, Hall F. Repurposed immunomodulatory drugs for Covid-19 in pre-ICu patients-mulTi-Arm Therapeutic study in pre-ICu patients admitted with Covid-19–Repurposed Drugs (TACTIC-R): A structured summary of a study protocol for a randomised controlled trial. Trials. 2020 ;21(1):1–3.CrossRef Kulkarni S, Fisk M, Kostapanos M, Banham-Hall E, Bond S, Hernan-Sancho E, Norton S, Cheriyan J, Cope A, Galloway J, Hall F. Repurposed immunomodulatory drugs for Covid-19 in pre-ICu patients-mulTi-Arm Therapeutic study in pre-ICu patients admitted with Covid-19–Repurposed Drugs (TACTIC-R): A structured summary of a study protocol for a randomised controlled trial. Trials. 2020 ;21(1):1–3.CrossRef
21.
go back to reference Urwyler P, Charitos P, Moser S, Heijnen IA, Trendelenburg M, Thoma R, Sumer J, Camacho-Ortiz A, Bacci MR, Huber LC, Stüssi-Helbling M. Recombinant human C1 esterase inhibitor (conestat alfa) in the prevention of severe SARS-CoV-2 infection in hospitalized patients with COVID-19: A structured summary of a study protocol for a randomized, parallel-group, open-label, multi-center pilot trial (PROTECT-COVID-19). Trials. 2021 ;22(1):1–3.CrossRef Urwyler P, Charitos P, Moser S, Heijnen IA, Trendelenburg M, Thoma R, Sumer J, Camacho-Ortiz A, Bacci MR, Huber LC, Stüssi-Helbling M. Recombinant human C1 esterase inhibitor (conestat alfa) in the prevention of severe SARS-CoV-2 infection in hospitalized patients with COVID-19: A structured summary of a study protocol for a randomized, parallel-group, open-label, multi-center pilot trial (PROTECT-COVID-19). Trials. 2021 ;22(1):1–3.CrossRef
22.
go back to reference I-SPY, COVID-19. TRIAL: an adaptive platform trial for critically ill patients full text view. Available from: ClinicalTrials.gov. Accessed May23, 2021. I-SPY, COVID-19. TRIAL: an adaptive platform trial for critically ill patients full text view. Available from: ClinicalTrials.gov. Accessed May23, 2021.
23.
go back to reference Boudhabhay I, Rabant M, Roumenina LT, Coupry LM, Poillerat V, Marchal A, Frémeaux-Bacchi V, El Karoui K, Monchi M, Pourcine F. Case Report: Adult Post-COVID-19 Multisystem Inflammatory Syndrome and Thrombotic Microangiopathy. Front Immunol. 2021;23:2284. Boudhabhay I, Rabant M, Roumenina LT, Coupry LM, Poillerat V, Marchal A, Frémeaux-Bacchi V, El Karoui K, Monchi M, Pourcine F. Case Report: Adult Post-COVID-19 Multisystem Inflammatory Syndrome and Thrombotic Microangiopathy. Front Immunol. 2021;23:2284.
24.
go back to reference Mentese IB, Velioglu A, Aykent B, Gunay DS, Arikan H, Tuglular S. Course of COVID-19 Pneumonia in a Kidney Transplant Patient Receiving Eculizumab. Progress in Transplantation. Jun. 2021;18:15269248211024629. Mentese IB, Velioglu A, Aykent B, Gunay DS, Arikan H, Tuglular S. Course of COVID-19 Pneumonia in a Kidney Transplant Patient Receiving Eculizumab. Progress in Transplantation. Jun. 2021;18:15269248211024629.
25.
go back to reference Sokol J, Nehaj F, Mokan M, Lisa L, Stasko J. COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report. Medicine. 2021 May 21;100(20). Sokol J, Nehaj F, Mokan M, Lisa L, Stasko J. COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report. Medicine. 2021 May 21;100(20).
Metadata
Title
COVID19 infection in a patient undergoing treatment for Paroxysmal Nocturnal Hemoglobinuria (PNH) with Ravulizumab
Authors
Sufana Shikdar
Azra Borogovac
Elabdallah Mohamad
Mohamad Khawandanah
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Thrombosis Journal / Issue 1/2021
Electronic ISSN: 1477-9560
DOI
https://doi.org/10.1186/s12959-021-00330-6

Other articles of this Issue 1/2021

Thrombosis Journal 1/2021 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.