Agranulocytosis Following COVID-19 Recovery

Forat Lutfi; Amin Benyounes; Naveed Farrukh; Jacqueline Bork; Vu Duong

doi:10.7759/cureus.9463

Agranulocytosis Following COVID-19 Recovery

Cureus. 2020 Jul 29;12(7):e9463. doi: 10.7759/cureus.9463.

Authors

Forat Lutfi¹, Amin Benyounes², Naveed Farrukh³, Jacqueline Bork⁴, Vu Duong⁵

Affiliations

¹ Oncology, University of Maryland Medical Center, Baltimore, USA.
² Hematology and Oncology, University of Maryland Medical Center, Baltimore, USA.
³ Internal Medicine, University of Maryland Medical Center, Baltimore, USA.
⁴ Infectious Disease, University of Maryland Medical Center, Baltimore, USA.
⁵ Hematology and Medical Oncology, University of Maryland Medical Center, Baltimore, USA.

Abstract

Clinicians have continued to report on the clinical behavior and characteristics of patients with coronavirus disease 2019 (COVID-19) as our knowledge of the virus continues to mature. Herein, we report the case of a 39-year-old male with multiple comorbidities who became critically ill with COVID-19 infection, requiring mechanical ventilation and vasopressors, and then developed agranulocytosis following clinical improvement and resolution of symptoms of COVID infection. The period of agranulocytosis coincided with the development of thrombocytosis, and following resolution of agranulocytosis, the platelet count also normalized, suggesting a possible related mechanism. Interestingly, the patient was treated with TBO-filgrastim 480 mcg daily with a rapid reconstitution of neutrophils. While the mechanism of agranulocytosis remains unknown, we report, to our knowledge, the first known case of agranulocytosis following COVID-19 infection and its successful treatment with granulocyte colony-stimulating factor.

Keywords: agranulocytosis; coronavirus; covid-19; neutropenia.

Publication types

Case Reports