Severe COVID-19 Pneumonia in a 3-year-old with Congenital Iron and B12 Deficiency Anemia of Unknown Etiology: A Case Report
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Kopš brīža kad Uhaņā, Ķīnā parādījās pirmie COVID-19 gadījumu un PVO to pasludināja par globālu pandēmiju, pētnieki ir rūpīgi pētījuši slimību un tās izraisītās komplikācijas. Tā kā pētījumu par COVID-19 slimību ar smagu norisis bērnu vidū ir maz, izveidot visaptverošu ārstēšanas protokolu ir ļoti sarežģīti. Šajā kliniskajā ziņojumā ir aprakstīts ārstēšanas protokols trīs gadus vecam bērnam, kurš tika hospitalizēts Bērnu klīniskajā universitātes slimnīcā smagas COVID-19 slimības norises dēļ, paralēli iepriekš diagnosticētai ilgstošai kombinētas dzelzs un B12 vitamīna deficīta izraisītai anēmijai. Tika konstatēts, ka pacienta klīniskais stāvoklis atbilst zinātniskajā literatūrā aprakstītajām biomarķieru novirzēm, tostarp limfopēniju, palielinātu neitrofīlu/limfocītu attiecību (NLR), samazinātu limfocītu/C-reaktīvā proteīna attiecību (LCR), kā arī paaugstinātu iekaisuma marķieru, piemēram, CRP, D-dimēru un fibrinogēna līmeni. Pacientam attīstījās smaga divpusēja pneimonija, kā rezultātā bija nepieciešama invazīva ventilācija, augstas plūsmas skābekļa padeve, imūnsupresīva terapija ar deksametazonu un tocilizumabu, kā arī asins pārliešana un B12 vitamīna ievadīšana anēmijas novēršanai.
Ever since COVID-19 first emerged in Wuhan, China, and was declared a global pandemic by the WHO, researchers have been meticulously studying the disease and its complications. Studies of severe COVID-19 disease among pediatric populations are scarce, leading to difficulty in establishing a comprehensive management approach. This report outlines a case of a long-standing combined iron and vitamin B12 deficiency anemia in a three-year-old treated at the Children’s Clinical University Hospital due to severe COVID-19 disease. The patient’s clinical condition was found to coincide with the derangement of biomarkers described in the literature, including lymphopenia, increased neutrophil/lymphocyte ratio (NLR), and decreased lymphocyte/C-reactive protein ratio (LCR), as well as elevated inflammatory markers such as CRP, D-dimers, and fibrinogen. The patient developed severe bilateral pneumonia requiring invasive ventilation, high-flow oxygen, immunosuppressive therapy in the form of dexamethasone and Tocilizumab, and supplementation of anemia deficits with blood transfusion and vitamin B12 administration.
Ever since COVID-19 first emerged in Wuhan, China, and was declared a global pandemic by the WHO, researchers have been meticulously studying the disease and its complications. Studies of severe COVID-19 disease among pediatric populations are scarce, leading to difficulty in establishing a comprehensive management approach. This report outlines a case of a long-standing combined iron and vitamin B12 deficiency anemia in a three-year-old treated at the Children’s Clinical University Hospital due to severe COVID-19 disease. The patient’s clinical condition was found to coincide with the derangement of biomarkers described in the literature, including lymphopenia, increased neutrophil/lymphocyte ratio (NLR), and decreased lymphocyte/C-reactive protein ratio (LCR), as well as elevated inflammatory markers such as CRP, D-dimers, and fibrinogen. The patient developed severe bilateral pneumonia requiring invasive ventilation, high-flow oxygen, immunosuppressive therapy in the form of dexamethasone and Tocilizumab, and supplementation of anemia deficits with blood transfusion and vitamin B12 administration.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
COVID-19, anēmija, pediatrija, biomarķieri, sepse, COVID-19, anemia, pediatrics, biomarkers, sepsis