Serological Blood Group Discrepancy and Cold Agglutinin Autoimmune Hemolytic Anemia Associated With Novel Coronavirus

A case of a 45-year-old male presentation with viral pneumonia with anemia and thrombocytopenia and was admitted to COVID-19 ICU. The blood bank encountered a discrepancy in blood grouping and cross-match, which were subsequently resolved. The patient presented to the emergency room with fever and shortness of breath. He had tachycardia, fever, and had an oxygen saturation of 88% on room air. His SARS-CoV-2 RT-PCR test was positive. Total and unconjugated bilirubin was raised. Due to the anemia and falling haemoglobin, he was not started on any anticoagulation. On investigation, the patient's direct Antiglobulin test was positive. Cold agglutinin titer at 4-degree Celsius was 64. The blood sample showed auto agglutination at collection and discrepancy in blood grouping and cross-matching, which were subsequently resolved. As observed in this case report, COVID-19 infection can be associated with cold agglutinin disease and Autoimmune hemolytic anemia, and cold agglutinins should be recognized as potentially significant due to interference with laboratory investigations and complications associated with COVID 19.