Autoimmune hemolytic anemia in COVID-19 patients: A systematic review of 105 cases on clinical characteristics and outcomes

BACKGROUND: COVID-19 has been linked to autoimmune hemolytic anemia (AIHA), a rare but serious condition causing red blood cell destruction. This systematic review examines the clinical characteristics, management, and outcomes of AIHA in COVID-19 patients. METHODS: A systematic search of PubMed, CINAHL, and Scopus identified 85 studies encompassing 105 patients. Data on demographics, clinical features, and treatment outcomes were extracted. RESULTS: Of 1402 articles, 85 met inclusion criteria. Most patients were male (54.3 %) with a mean age of 50.6 years, predominantly from Asia (83.5 %). Cold agglutinin AIHA was most common (48.2 %). Presenting symptoms included fatigue, dyspnea, and fever. Steroids were the most effective treatment, used in 95 % of recovered cases. Mortality was 14.3 %, with 26.7 % of deaths directly related to AIHA. CONCLUSIONS: COVID-19 is associated with AIHA, often presenting with non-specific symptoms. Early recognition and prompt steroid therapy are critical for improving outcomes. Further research is needed to guide management.