Evans syndrome in the course of COVID-19 infection; essentials and approaches

Redundant studies proved coronavirus infection results from a defect in a suitable immune response that may exacerbate immune-inflammatory reactions like cytokine storm and autoimmunity. Evans syndrome (ES) is a rare chronic autoimmune disease that distinguishes it from autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP). Reports have shown significant differences in immune cells and laboratory parameters in Evans syndrome/COVID-19 co-infected patients. Also, the contribution between autoimmune diseases and SARS-CoV-2 infection could result in immune response disequilibrium that considers a possible mechanism for ES development. Moreover, we will briefly explain the double-edged sword role of immunosuppressive drugs in Evans syndrome/ COVID-19 co-infected patients. Generally, the pathophysiology of SARS- CoV-2 in hematologic autoimmune disorders progression, particularly ES, remains unclear, but some investigations explain the COVID-19 infection mechanism in the mentioned disorders development. The purpose of the current study is to look at the coronavirus effects on Evans syndrome aggravation, the immune cells and laboratory markers alterations in Evans syndrome/COVID-19 co-infected patients, the coronavirus effects on Evans syndrome patients during their pregnancy, and the Evans syndrome / COVID-19 co-infected patient management.