Introduction
Infection with severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) has been reported to cause a myriad of manifestations and
complications in both children and adults. One of the less reported
phenomena relates to its effect on the bone marrow. There are several
documented cases of idiopathic thrombocytopenic purpura (ITP) as well as
autoimmune hemolytic anemia (AIHA) secondary to SARS-CoV-2 infection.
However, limited evidence exists for transient severe neutropenia in the
setting of an acute diagnosis of COVID-19 infection in pediatric
patients.1,2 Xu et al3 described the
mechanism of thrombocytopenia related to COVID-19 as multifactorial
including lung injury resulting in increased platelet consumption,
direct infection of bone marrow stromal cells, and cytokine storm
resulting in destruction of bone marrow progenitor cells. Likewise,
there are documented cases of lymphopenia secondary to proposed
lymphocyte apoptosis during inflammatory storms.4Additionally, two cases of severe neutropenia in neonates have been
reported by Venturini et al5 in association with mild
COVID-19. We present a case of a 17-year-old female diagnosed with
laboratory confirmed SARS-CoV-2 infection with leukopenia,
thrombocytopenia, and severe neutropenia who was cared for at our
academic community-based tertiary center.