Atypical Hemolytic Uremic Syndrome and Super-infection after COVID-19

  • Majid Malaki Assistant Professor, Department of Pediatric Nephrology, NICU ward of Mardom Hospital (Bahadori Hospital), Tehran, IRAN.


Atypical haemolytic uremic syndrome (HUS) following pneumococcal infection is a rare but can be serious.[1] In fact many renal findings such as rising serum LDH, thrombocytopenia and rising creatinine after COVID-19 can be misleading us for pneumococcal infection solely or co-infection and its complication named as atypical HUS but the incidence of such event and its relation with streptococcal pneumonia as a causative factor of atypical HUS is unknown. There are different incidences of acute kidney injury (AKI) following COVID-19 not only among countries but cities of a country with same management guidelines,[2] many case series tried to identify the role of super-infection in COVID-19 but none hinted the incidence of AKI in them, 16 agents identified as super-infection as a high event (49.6%) in COVID 19 include of Klebsiella (pneumonia and oxytoca) and Staphylococcus aureus as the most frequent.[3] It seems that atypical HUS following in COVID 19 is not a common finding because of it is defined in cases reports without known causative factor that mostly recovered by using eculizumab.[4] Such evidences show streptococcal pneumonia has not any role as a super-infection during COVID-19 or inciting factor in atypical HUS that may be seen rarely during COVID-19 epidemics bring vaccination against pneumococcus into question because of it cannot cover all serotypes and insufficient immunogenicity specially in renal failure or after organ transplantation[5] on the other side necrotizing pneumonia (NP) as prototype of invasive pneumococcus that may herald of severe forms of renal failure was not reported following COVID-19. During COVID-19 most of NP occur as a late complication of COVID-19 mainly due to Klebsiella pneumonia and Pseudomonas aeruginosa super-infection without significant AKI occurrence or atypical HUS in affected cases.[6]. Read More...

Atypical Hemolytic Uremic Syndrome and Super-infection after COVID-19
How to Cite
Malaki, M. (2022). Atypical Hemolytic Uremic Syndrome and Super-infection after COVID-19. International Journal of Clinical and Experimental Physiology, 9(2), 101.