RESUMO
Warm antibody autoimmune hemolytic anemia (WAIHA) is a rare disease that leads to the destruction of red blood cells in the reticuloendothelial system through the mediation of agglutinins (immunoglobulin G (IgG) type in most cases) that attach to the erythrocyte wall at 37 °C. The association of WAIHA and venous thromboembolism (VTE) seems to be higher than other hemolytic disorders classically associated with VTE and there is a current investigation aimed at clarifying this association and establishing some criteria to use anticoagulant treatment in patients with WAIHA. Despite this, WAIHA is a rare cause for the development of recurrent VTE under secondary prophylactic anticoagulant treatment, with only a few cases described in the literature. We present the case of a patient who developed a recurrence of deep vein thrombosis during a WAIHA episode despite treatment with acenocoumarol and a review of the literature.
RESUMO
OBJECTIVE: The role of hypertension in COVID-19 has not been clearly elucidated yet. The aim of this study was to evaluate the incidence and severity of COVID-19 in a hypertensive population and assess whether there is a link between blood pressure control and SARS-CoV-2 infection outcomes. METHODS: This was a single-center retrospective observational study that evaluated the incidence and severity of COVID-19 in a chronic hypertensive population (n=1,637) from a specialized consultation of Hypertension and Cardiovascular Risk of Internal Medicine in a tertiary hospital in Madrid (Spain). RESULTS: A total of 147 COVID-19 patients (9%) were found, with a median age of 59 (±14) years, where 77 (52.4%) patients were male. Forty patients required hospitalization (27.2%), 15 patients had severe COVID-19 (10.2%), and 6 patients died (4.1%). Among the causes of hypertension, 104 (70.7%) patients had essential hypertension and 22 (15%) patients presented primary hyperaldosteronism; and 66 (44.9%) patients presented RH. Severe COVID-19 was associated with age over 65 years (crude OR 4.43 [95% CI 1.3-14.2; p = .012]) and diabetes mellitus (crude OR 4.15 [95% CI 1.3-12.9; p = .014]). CONCLUSION: This study showed a lower rate of incidence, hospitalization, and severity of COVID-19 in the hypertensive population.