Comparison of the clinical course of COVID-19 infection in sickle cell disease patients with healthcare professionals

Abstract

It is highly expected that COVID-19 infection will have devastating consequences in sickle cell disease (SCD) patients due to endothelial activation and decreased tissue and organ reserve as a result of microvascular ischemia and continuous inflammation. In this study, we aimed to compare the clinical course of COVID-19 in adult SCD patients under the organ injury mitigation and clinical care improvement program (BASCARE) with healthcare professionals without significant comorbid conditions. The study was planned as a retrospective, multicenter and cross-sectional study. Thirty-nine SCD patients, ages 18 to 64 years, and 121 healthcare professionals, ages 21 to 53, were included in the study. The data were collected from the Electronic Health Recording System of PRANA, where SCD patients under the BASCARE program had been registered. The data of other patients were collected from the Electronic Hospital Data Recording System and patient files. In the SCD group, the crude incidence of COVID-19 was 9%, while in healthcare professionals at the same period was 23%. Among the symptoms, besides fever, loss of smell and taste were more prominent in the SCD group than in healthcare professionals. There was a significant difference between the two groups in terms of development of pneumonia, hospitalization, and need for intubation (43 vs 5%, P < 0.00001; 26 vs 7%, P = 0.002; and 10 vs 1%, P = 0.002, respectively). Prophylactic low molecular weight heparin and salicylate were used more in the SCD group than in healthcare professionals group (41 vs 9% and 28 vs 1%; P < 0.0001 for both). The 3-month mortality rate was demonstrated as 5% in the SCD group, while 0 in the healthcare professionals group. One patient in the SCD group became continously dependent on respiratory support. The cause of death was acute chest syndrome in the first case, hepatic necrosis and multi-organ failure in the second case. In conclusion, these observations supported the expectation that the course of COVID-19 in SCD patients will get worse. The BASCARE program applied in SCD patients could not change the poor outcome.

COVID‐19 infection and the broader impacts of the pandemic on healthcare workers

“…32 Additionally, a retrospective cohort study of 121 HCWs, which was collected as part of a comparative study of COVID-19 illness in patients with sickle cell disease, identified that 23% of HCWs acquired COVID-19 infection over a 6-month period from June 2020 to January 2021. 36 These HCWs often had mild symptoms, with myalgia being the most commonly reported (66%); only 8% had abnormalities on chest radiograph and 2% had severe pneumonia or ARDS. 36 A structured retrospective review of patients with COVID-19 infection presenting to a large tertiary hospital in New York identified 193 HCWs amongst 2842 patients.…”

“…36 These HCWs often had mild symptoms, with myalgia being the most commonly reported (66%); only 8% had abnormalities on chest radiograph and 2% had severe pneumonia or ARDS. 36 A structured retrospective review of patients with COVID-19 infection presenting to a large tertiary hospital in New York identified 193 HCWs amongst 2842 patients. 37 HCWs were generally younger in age and had fewer comorbidities than the remainder of the cohort.…”

“…Data on thrombo‐embolic events were recorded in a total of 159 HCWs, of whom 6% had pulmonary embolism 32 . Additionally, a retrospective cohort study of 121 HCWs, which was collected as part of a comparative study of COVID‐19 illness in patients with sickle cell disease, identified that 23% of HCWs acquired COVID‐19 infection over a 6‐month period from June 2020 to January 2021 36 . These HCWs often had mild symptoms, with myalgia being the most commonly reported (66%); only 8% had abnormalities on chest radiograph and 2% had severe pneumonia or ARDS 36 …”

Three-dose mRNA-1273 vaccination schedule: sufficient antibody response in majority of immunocompromised hematology patients

“…Patient inclusion. Details on 1 patients that did not receive a 3 rd vaccination during the time under study are depicted in eTable 2, and on 2 patients that received cell therapy between the 2 nd and 3 rd vaccination in eTable 4.…”

“…Patients with hematologic diseases are at high risk for severe coronavirus disease 2019 (COVID-19), COVID-19-related death, and persistent viral shedding, also in the omicron era. [1][2][3][4][5] While vaccination has demonstrated efficacy against COVID-19related hospital admission and death in healthy individuals, [6][7][8] several studies among COVID-19 vaccinated hematology patients demonstrated reduced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroconversion rates [9][10][11][12][13][14][15][16] and lowered COVID-19 vaccine effectiveness. 17,18 Reduced vaccine immunogenicity in hematology patients is related to the disease itself and the therapy thereof.…”