Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Original Article

Volume 16, Number 1, January 2024, pages 8-14

Cold Agglutinin Disease and COVID-19: A Scoping Review of Treatments and Outcomes


Figure 1.
Figure 1. Study selection flow diagram: adapted from the PRISMA. PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.


Table 1. Main Characteristics of Included Studies
Author, yearCountryStudy typeAge (years)/sexCAD status (pre-existing/new diagnosis)Clinical presentationComorbidityTreatment with rituximabCOVID-19 treatmentCAD treatmentTime to AIHAICU admissionOverall outcome
COVID-19: coronavirus disease 2019; CAD: cold agglutinin disease; AIHA: autoimmune hemolytic anemia; ICU: intensive care unit; F: female; M: male; RBC: red blood cell; ESRD: end-stage renal disease; COPD: chronic obstructive pulmonary disease.
Zagorski et al, 2020 [13]USACase report46/FNewAnemiaImmune thrombocytopenic purpura (ITP), post splenectomy/iron deficiency anemia, asthmaNoSupportive onlyPacked RBC transfusionConcomitantNoDied
Tsukamoto et al, 2022 [14]JapanCase report72/FNewAnemiaNot reportedNoSteroidsSteroidsConcomitantYesResolved
Ramos-Ruperto et al, 2021 [15]SpainCase series54/MNewSevere pneumoniaNo significant medical historyNoHydroxychloroquine and tocilizumabSteroids and plasma exchangeConcomitantNoResolved
72/FNewSevere pneumoniaNo significant medical historyNoHydroxychloroquine, tocilizumab, and steroidsSteroids and packed RBC transfusionNot reportedYesResolved
76/FNewSevere pneumoniaHypertension, hypothyroidism, chronic lymphocytic leukemia (no previous treatment)NoHydroxychloroquine and steroidsSteroids and packed RBC transfusionNot reportedYesResolved
Raghuwanshi et al, 2020 [16]IndiaCase report45/MNewPneumonia with anemia and thrombocytopeniaNot reportedNoNot reportedPacked RBC transfusionNot reportedYesNo reported outcome
Priyadarshini et al, 2022 [17]IndiaCase report43/MNewSevere pneumoniaNot reportedNoRemdesivir and steroidsPacked RBC transfusion2 daysYesDied
Patil et al, 2020 [18]USACase report51/FNewSevere pneumoniaBreast ductal carcinoma status post lumpectomy/radiation therapy/tamoxifenNoHydroxychloroquinePacked RBC transfusionConcomitantNoResolved
Moonla et al, 2020 [19]ThailandCase report24/FNewSevere pneumoniaNo significant medical historyNoHydroxychloroquineNone3 daysNoResolved
Maslov et al, 2020 [20]USACase report48/MNewAnemiaHypertension, insulin-dependent diabetes mellitus, obesity/ESRD on hemodialysisNoSupportive onlyNoneConcomitantNoDied
Lazarian et al, 2020 [21]French and BelgianCase series62/FNewSevere pneumoniaHypertension, cirrhosisYesNot reportedSteroid and rituximab4 daysNoResolved
69/FNewModerate pneumoniaObesityNoNot reportedSteroids10 daysNoResolved
61/MNewMild pneumoniaHypertension, chronic renal failureNoNot reportedPacked RBC transfusion11 daysNoActive hemolysis at publication
Kaur et a, 2021 [22]USACase report61/MNewHypoxic respiratory failureHypertension, type 2 diabetes mellitus, hypercholesterolemia, ESRD, hemodialysis-dependent, anemia of chronic disease, coronary artery disease, paroxysmal atrial fibrillation, and obesityNoHydroxychloroquine, steroids, azithromycinPacked RBC transfusion21 daysYesResolved
Jacobs et al, 2021 [23]USACase report33/FNewAnemiaNo significant medical historyYesSteroids and tocilizumabRituximab and packed RBC transfusionConcomitantYesResolved
Gupta et al, 2021 [24]USACase report77/MNewPneumoniaCOPD and glucose-6-phosphate dehydrogenase (G6PD)NoHydroxychloroquine, steroids, unspecified antibioticsPacked RBC transfusion9 daysYesDied
Chang et al, 2022 [25]MalaysiaCase report70/FNewPneumoniaType 2 diabetes mellitus, hypertension, and dyslipidemiaNoSteroidsPacked RBC transfusion3 daysYesResolved
Capes et al, 2020 [26]BelgiumCase report62/MNewPneumoniaOropharyngeal squamous cell carcinoma on radio chemotherapyNoIntubationPacked RBC transfusion16 daysYesResolved
Bhuyan et al, 2022 [27]IndiaCase report45/FNewAnemiaNo significant medical historyNoSupportive onlyPacked RBC transfusionConcomitantYesResolved
Bhagat et al, 2021 [28]USACase report83/FExistingAnemiaCold agglutinin hemolytic anemia, chronic anemia, hypothyroidism, hypertension, deep vein thrombosis and chronic lymphedemaYesRemdesivir and steroidsRituximab and packed RBC transfusionConcomitantNoResolved
Aldaghlawi et al, 2021 [29]USACase report69/FNewNonspecific symptomsStage IV chronic lymphocytic leukemia on tirabrutinibYesLevofloxacin, steroidsRituximab, steroids20 daysNoResolved
Ahmed et al, 2021 [30]CanadaCase report70/MExistingPneumoniaCold agglutinin disease, gout, and chronic viral hepatitis B without cirrhosisNoSteroidsPacked RBC transfusion and plasma exchangeConcomitantYesResolved
Ahmadnezhad et al, 2021 [31]IranCase report49/FNewAnemiaThalassemiaNoSupportive onlyPacked RBC transfusionConcomitantNoDied