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Haemolytic anaemia: a consequence of COVID-19
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  • Published on: 26 April 2021
    Response from authors
    • Jawed Memoona, Acute Medicine) Nottinghamshire University Hospitals NHS Trust

    Dear Sir/Madam,

    Thank you for your comments

    Please see below for clarification to your queries:

    1) What was Central Venous Pressure:

    The CVP pressure was not measured as the patient was relatively well. Are you perhaps referring to JVP which was unremarkable.

    2) If patient was, presumably Conscious, Oriented, able to take Food and Fluids by Mouth, could the Intravenous Administration of Fluids be avoided?

    It is possible that IV fluids could have been avoided but in view of his AKI it was felt prudent to rehydrate with IV fluids. We appreciate that management in this scenario will differ.

    3) How did the Elevated Blood Pressure evolved during Hospitalization, either with or without Medications.

    He had only one dose of amlodipine as inpatient and didn’t require any further doses for BP control. On discharge his Blood pressure was within normal limits and his GP was advised to continue monitoring his blood pressure as he had previously been doing.

    4) What was Patient's Diet and Fluid Intake Both Quantitative and Qualitative during the Hospitalization?

    AKI resolved within 24 hours of admission so exact fluid intake, urinary output and diet were not documented.

    5) Whether the Patient took any Formal or Alternative Medicines or Home Remedies for Coryza he had Two Weeks before Episode of Shortness of Breath, that could have caused Autoimmune Hemolysis?

    The patient had not...

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    Conflict of Interest:
    None declared.
  • Published on: 26 April 2021
    Diagnosis, Plausible but Difficult to Establish.
    • Arvind Joshi, Founder Convener and President Our Own Discussion Group & Consultant Physician. Our Own Discussion Group Mumbai PIN 400028; Ruchi Diagnostic Center and Ruchi Clinical Laboratory Kharghar PIN 410210; INDIA.

    Some more information will make the Case Presentation more Illuminating and Educative, such as:
    1) What was Central Venous Pressure,
    2) If patient was, presumably Conscious, Oriented, Able to take Food and Fluids by Mouth, could the Intravenous Administration of Fluids be avoided,
    3) How did the Elevated Blood Pressure evolved during Hospitalization, either with or without Medications,
    4) What was Patient's Diet and Fluid Intake Both Quantitative and Qualitative during the Hospitalization,
    5) Whether the Patient took any Formal or Alternative Medicines or Home Remedies for Coryza he had Two Weeks before Episode of Shortness of Breath, that could have caused Autoimmune Hemolysis.
    5) If the Patient's Blood Pressure before Present Illnesses was known and if he took any medications for it and any other conditions eg Bleeding per Rectum,
    6) What were the instructions including those regarding medications diet and follow-up given to the Patient at the time of Discharge.
    The Authors need to be complimented for seeing the patient through the crisis and The BMJ be thanked for bringing it up to the Readers.

    Conflict of Interest:
    None declared.