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<article xlink="http://www.w3.org/1999/xlink" dtd-version="1.0" article-type="internal-medicine" lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher">JOHS</journal-id>
      <journal-id journal-id-type="nlm-ta">Journ of Health Scien</journal-id>
      <journal-title-group>
        <journal-title>Journal of HealthCare Sciences</journal-title>
        <abbrev-journal-title abbrev-type="pubmed">Journ of Health Scien</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2231-2196</issn>
      <issn pub-type="opub">0975-5241</issn>
      <publisher>
        <publisher-name>Radiance Research Academy</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">259</article-id>
      <article-id pub-id-type="doi">http://dx.doi.org/10.52533/JOHS.2024.40110</article-id>
      <article-id pub-id-type="doi-url"/>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Internal Medicine</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>A Case of Non-Immune Mediated Hemolysis Associated with COVID-19 Infection and Review of Literature&#13;
</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Al-Fararjeh</surname>
            <given-names>Feras</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Al-Abbadi</surname>
            <given-names>Abdullah Saleh</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Al-Adily</surname>
            <given-names>Tariq Nazih</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Abdulrasoul</surname>
            <given-names>Bashayer Sadiq</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Al-Razouqi</surname>
            <given-names>Sarah Sayed</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname/>
            <given-names/>
          </name>
        </contrib>
      </contrib-group>
      <pub-date pub-type="ppub">
        <day>13</day>
        <month>01</month>
        <year>2024</year>
      </pub-date>
      <volume>4</volume>
      <issue>1	</issue>
      <fpage>77</fpage>
      <lpage>85</lpage>
      <permissions>
        <copyright-statement>This article is copyright of Popeye Publishing, 2009</copyright-statement>
        <copyright-year>2009</copyright-year>
        <license license-type="open-access" href="http://creativecommons.org/licenses/by/4.0/">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.</license-p>
        </license>
      </permissions>
      <abstract>
        <p>Background: COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents a broad spectrum of clinical manifestations, ranging from mild symptoms to severe conditions requiring intensive care. Beyond its well-known respiratory complications, COVID-19 has been increasingly associated with various immune and hematological complications, including cases of hemolytic anemia. This report adds to the emerging evidence linking COVID-19 to hematological abnormalities, specifically non-immune mediated hemolytic anemia (NIHA).&#13;
&#13;
Case Presentation: We report a case of NIHA associated with COVID-19 infection. A 35-year-old male nurse, with no prior health issues or medication allergies, presented with symptoms of generalized weakness, fever, exertional dyspnea, heart palpitations, and dark urine, leading to a COVID-19 diagnosis. Initial examinations revealed fever and jaundice, but normal chest x-ray and oxygen saturation levels. Hematological investigations indicated hemolytic anemia, with a negative direct Coombs test and normal G6PD levels, excluding autoimmune causes and G6PD deficiency. Following treatment with intravenous fluids, paracetamol, and dexamethasone, his symptoms rapidly improved, and subsequent tests three months later confirmed the resolution of hemolysis and normalization of hemoglobin levels.&#13;
&#13;
Conclusion: In COVID-19 infections, various hematological complications can lead to hemolysis, often associated with factors like G6PD deficiency, specific medications, or autoimmune reactions. This report details a unique case of non-immune mediated hemolysis in a patient exhibiting symptomatic COVID-19, notably in the absence of these common hemolytic triggers. The case highlights the need for heightened awareness of atypical hematological presentations in COVID-19 patients.&#13;
</p>
      </abstract>
      <kwd-group>
        <kwd>COVID-19</kwd>
        <kwd> Direct Coombs test</kwd>
        <kwd> hemoglobin</kwd>
        <kwd> non-immune hemolytic anemia</kwd>
      </kwd-group>
    </article-meta>
  </front>
</article>