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.