# Pure red cell aplasia post-SARS-CoV-2 infection: a case report in an HIV-positive patient

## TL;DR

A patient with HIV developed pure red cell aplasia after SARS-CoV-2 infection and recovered with immunosuppressive therapy.

## Contribution

This is the first reported case of SARS-CoV-2-associated pure red cell aplasia in an HIV-positive individual.

## Key findings

- The patient achieved complete remission with immunosuppressive therapy, including corticosteroids and cyclosporine A.
- SARS-CoV-2 infection can cause hematological abnormalities, including bone marrow involvement.
- HIV-positive patients with PRCA should have antiretroviral drugs and infections prioritized in diagnostic evaluations.

## Abstract

We present a case of Pure Red Cell Aplasia (PRCA) secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a human immunodeficiency virus (HIV)-positive patient. To our knowledge, this is the first reported case of SARS-CoV-2-associated PRCA in an HIV-positive individual. The patient received immunosuppressive therapy (IST):initial treatment with corticosteroids was later switched to cyclosporine A (CsA), and he ultimately achieved complete remission. Additionally, we reviewed previously reported cases of SARS-CoV-2-associated PRCA. These findings emphasize that hematological abnormalities should also be recognized as a critical extrapulmonary complication of SARS-CoV-2 infection. In conclusion, SARS-CoV-2 infection can affect bone marrow tissue, leading to a spectrum of hematological abnormalities and subsequent clinical sequelae. For HIV-positive patients presenting with PRCA, antiretroviral drugs and acute or chronic infections should be prioritized in the diagnostic workup.