A Case of COVID-19 Infection Associated with Severe Cold Agglutinin Autoimmune Haemolytic Anaemia

Background: COVID-19 is known to cause systemic disease with multiple organ dysfunctions. COVID-19 associated immune-mediated phenomena such as autoimmune haemolytic anaemia has been identified previously with rare incidence. However, the association between COVID-19 infection and autoimmune haemolytic anaemia is not fully evaluated. Case presentation: Here, we present a case of a previously well patient who developed severe cold agglutinin hemolytic anemia during the course of COVID-19 infection. Although there were no thrombotic complications, he developed acute kidney injury and COVID-19 lung involvement during the course of the disease. He was successfully treated with blood transfusion, oxygen therapy, corticosteroids and antibiotics and, best supportive care. Conclusion: Although it is an uncommon presentation, clinicians need to be aware of COVID-19 infectionassociated autoimmune manifestations including warm and cold type haemolytic anaemia. This case emphasizes the importance of an extensive diagnostic workup to identify autoimmune haemolytic anaemia in COVID-19 patients who could present with severe anaemia which requires timely management to save their lives.