Researchers from around the world have been investigating the potential connection between SARS-CoV-2 infections and aplastic anaemia (AA), a rare and life-threatening disorder. Cases of AA following COVID-19 or its vaccination have been reported in various countries, including Japan, South Korea, Italy, China, Taiwan, the United Kingdom, and the United States.
Aplastic anaemia is a serious condition characterized by bone marrow failure, where the body fails to produce enough new blood cells. This condition leaves individuals fatigued and susceptible to infections and bleeding. Stem cell damage in the bone marrow, responsible for producing blood cells, is the primary cause of AA. When these stem cells are damaged, the production of red blood cells, white blood cells, and platelets is reduced, posing significant risks to the patient’s life. Recent advancements in treatment have improved outcomes, with an overall five-year survival rate of around 80% for individuals under the age of 20. Although aplastic anaemia is not a form of cancer, it may sometimes be associated with leukemia.
In a groundbreaking case study from Changsha, China, researchers present the case of a 14-year-old female patient who developed AA after contracting SARS-CoV-2. The study analyzed the incidence rates of blood system diseases from July 2022 to May 2023 in two hospitals in Changsha. The results showed an increased detection rate of AA and leukemia in the first two months after the COVID-19 outbreak, with statistical significance observed only in leukemia cases. This highlights the need to understand the potential hematological consequences of COVID-19.
The patient in the case study was a previously healthy 14-year-old girl who had received two doses of the inactivated SARS-CoV-2 vaccine. After being infected with the Omicron variant in December 2022, she experienced a high fever and tested positive for SARS-CoV-2. Subsequently, she developed pancytopenia and was hospitalized in January 2023. Laboratory tests revealed a severe decline in blood cell counts, meeting the criteria for acquired AA. Despite ruling out other causes, including malignancy and infections, the exact cause remained unknown. The patient’s blood cells and plasma tested positive for SARS-CoV-2 nucleic acid even three months after the infection. A bone marrow transplant from her father resulted in remission and a positive hematologic response.
The study discusses several potential mechanisms linking COVID-19 and AA, including excessive production of inflammatory cytokines, cytokine storms, direct cytotoxicity of the virus, abnormal hematopoiesis, aberrant immune response, myelosuppressive effects, and direct infiltration of the virus into the bone marrow. However, further investigations are needed to confirm these associations in larger groups of patients.
This study from Changsha emphasizes the urgent need to understand the potential links between SARS-CoV-2 infections and aplastic anaemia. The increase in detection rates of AA and leukemia during the early months of the pandemic suggests a possible connection. It is crucial for the scientific community to delve deeper into the hematological consequences of COVID-19 as part of the ongoing efforts to combat the global pandemic. This research can help us better understand the full spectrum of COVID-19-related complications and guide future preventive measures and treatments.