Introduction:
Hereditary spherocytosis (HS) is an inherited hemolytic disease which
has a wide spectrum of phenotypic expression ranging from asymptomatic
to chronic ongoing hemolysis1. Clinical findings of
this disease are due to genetic mutations in plasma membrane proteins
which result in an unstable red blood cell membrane-cytoskeleton
interaction. This dysfunctional interaction places the red blood cells
at higher risk for hemolysis triggered by various stressors including
fever and hypoxia.1-3 Splenic clearance of damaged red
blood cells results in anemia , thus patients are treated with
supportive transfusion and splenectomy can be utilized to decrease
chronic hemolysis in severely affected patients.4,5
The novel virus, severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2), which causes Coronavirus Disease 2019 (COVID-19), emerged
in Wuhan province in China in December 2019 and has affected over 2
million people globally as of April 2020.6 Many
studies have found that the spread of COVID-19 is very rapid due to the
highly contagious nature of the disease, resulting in a global
pandemic.7-10 While information about this virus is
still evolving, children have had less severe manifestations of COVID-19
with proportionately fewer pediatric cases requiring
hospitalization.11 In the US, a Center for Disease
Control Morbidity and Mortality Weekly Report found that children
account for 22% of the population but only 1.7% of overall COVID-19
cases.12 There is still much to learn regarding how
COVID-19 affects children with underlying chronic disorders and what
important clinical presentations and labs should be followed in patients
who have a chronic illness.
We describe a unique case of a pediatric patient infected with COVID-19
in the setting of a known chronic illness, HS, and the resulting
presentation and medical complications. This case report is published
with parental permission.