COVID-19 in patients with sickle cell disease - a case series from a UK Tertiary Hospital

Chakravorty, Subarna; Padmore-Payne, Giselle; Ike, Fester; Tshibangu, Virginia; Graham, Charlotte; Rees, David C.; Stuart‐Smith, Sara

doi:10.3324/haematol.2020.254250

Cited by 34 publications

(47 citation statements)

References 5 publications

(5 reference statements)

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“…This is a higher rate than observed in other published series to date in SCD cohorts. 15 - 22 , 27 Similar to most of the existing literature, the case fatality rate in SCD could be lower, as we were only aware of patients who were symptomatic and presented to the health care system.…”

Section: Discussionmentioning

confidence: 71%

“…We observed a wide spectrum of disease severity, ranging from minimal symptoms to multisystem organ failure and death. Several case series and 2 large cohort studies, one from Europe and one from the United States (the SECURE-SCD registry), 15 - 22 , 27 have reported on the clinical characteristics and mortality rate of patients with SCD and COVID-19. The US-based registry reported a 7% mortality in 178 patients, whereas the French cohort had 2 deaths in 83 patients.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several case series highlighting the impact of COVID-19 on patients living with SCD. 15 - 22 A recent report from France provided data on COVID-19 severity in hospitalized SCD patients did not appear markedly worse than the general population, which may be a reflection of a younger patient population (most affected patients were aged <45 years). 21 A US-based registry provided further data on morbidities and mortality risk associated with COVID-19 infection.…”

Section: Introductionmentioning

confidence: 93%

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Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection

et al. 2021

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We aimed to identify predictors of outcomes and survival in patients living in 4 major metropolitan areas who had sickle cell disease (SCD) and COVID-19 to inform best approaches to prevention and care. Data were collected at baseline and during the clinical course in SCD patients diagnosed with COVID-19 in four COVID-19 epicenters. Patients were followed up posthospital discharge for up to 3 months. Of sixty-six SCD patients with COVID-19, fifty patients (75%) required hospitalization, and seven died (10.6%). Patients with preexisting kidney disease (chronic kidney disease) were more likely to be hospitalized. The most common presenting symptom was vaso-occlusive pain. Acute chest syndrome occurred in 30 (60%) of the 50 hospitalized patients and in all who died. Older age and histories of pulmonary hypertension, congestive heart failure, chronic kidney disease, and stroke were more prevalent in patients who died, as were higher creatinine, lactate dehydrogenase, and D-dimer levels. Anticoagulation use while inpatient was twice less common in patients who died. All deaths occurred in individuals not taking hydroxyurea or any other SCD-modifying therapy. Patients with SCD and COVID-19 exhibited a broad range of disease severity. We cannot definitively state that the overall mortality is higher in patients with SCD, although our case fatality rate was ∼10% compared with ∼3% in the general population, despite a median age of 34 years. Individuals with SCD aged >50 years, with preexisting cardiopulmonary, renal disease, and/or stroke not receiving hydroxyurea, who present with high serum creatinine, lactate dehydrogenase, and D-dimer levels, are at higher risk of death, irrespective of genotype or sex.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

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Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection

et al. 2021

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“…Of the 49 documents found, 26 were excluded because they did not present patient data and, therefore, 23 were selected. 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 Of these, three more articles were excluded, as one was a report on a patient with sickle cell anemia after hematopoietic stem cell transplantation 14 and two were published case reviews, 15 , 16 totalizing 20 eligible scientific documents. Finally, four were exclusively pediatric descriptions (between zero and < 19 years old), 17 , 18 , 19 , 20 five described both pediatric and adult data 12 , 13 , 21 , 22 , 23 and 11 exclusively reported on adults.…”

Section: Methodsmentioning

confidence: 99%

Hemoglobinopathy and pediatrics in the time of COVID-19

Vilela

Braga

Loggetto

2021

Hematology, Transfusion and Cell Therapy

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Introduction It is important to know if patients with hemoglobinopathy could be more susceptible to COVID-19. Objective Analyze SARS-CoV-2 infection in pediatric patients with hemoglobinopathy. Methods Using the online platforms LILACS, PUBMED and EMBASE, on 17- JUL-2020 a search was made for the terms COVID-19 and SARS-CoV-2 associated with “sickle cell”, “thalassemia” and “hemoglobinopathy”. Results There were 623 pediatric and adult patients with sickle cell disease (SCD) or beta thalassemia (BT) and COVID-19. Total mortality rate was 6.42%. No pediatric patient with BT has been described. So, our analysis focused on children and adolescents with SCD: there were 121 pediatric patients, one adolescent died, prophylactic anticoagulation was prescribed to six patients, 11.76% needed intensive care unit, blood transfusion was prescribed in 29.70%. Vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) were the main clinical manifestations in SCD. Discussion Pediatric patients with SCD and COVID-19 have a low mortality rate when compared to adults, although is higher than the global pediatric population with COVID-19 (0−0.67%). The comorbidities associated with age and the long-term complications inherent to hemoglobinopathies may contribute to the increased mortality outside the pediatric age group. In SCD the clinical manifestations, both in children and adults, are VOC and ACS, and there was increase in blood requirement. Pediatric SCD patients with COVID-19 need more intensive care unit than the global pediatric population (3.30%). Conclusion Despite pediatric population with SCD needs more intensive care, the outcome after infection by COVID-19 is favorable.

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“…Other studies also showed similar results. Chakravotry et al39 explored COVID-19 disease outcomes of 10 SCD patients in a tertiary hospital in the United Kingdom. The study demonstrated that most patients had mild disease with 80% not requiring oxygen and the remaining 20% requiring only a nasal cannula.…”

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confidence: 99%

Is sickle cell disease a risk factor for severe COVID-19 : a multicenter national retrospective cohort

Abdulrahman

Mohamed

AlAmmadi

et al. 2021

Preprint

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IntroductionCoronavirus disease (COVID-19) caused by the novel coronavirus SARS-CoV-2 is an infectious disease which has evolved into a worldwide pandemic. Growing evidence suggests that individuals with pre-existing comorbidities are at higher risk of a more serious COVID-19 illness. Sickle cell disease (SCD) is an inherited hemoglobinopathy which increases the susceptibility to infections and as a consequent has higher risks of morbidity and mortality.The impact of COVID-19 on SCD patients could lead to further increase in disease severity and mortality. Studies that examine the effect of SCD on COVID-19 outcomes are lacking. This study aims to determine whether SCD is a risk factor for severe COVID-19 infection in regards to the requirement of non-invasive ventilation/high flow nasal cannula (NIV/HFNC), mechanical intubation (MV) or death.MethodsRetrospective cohort study which included COVID-19 patients admitted to four Ministry of Health COVID-19 treatment facilities in Bahrain during the period of 24, February 2020, to 31, July 2020. All SCD patients with COVID-19 were included and compared to randomly selected non-SCD patients with COVID-19. Data for the selected patients were collected from the medical records. Multivariate logistic regression models were used to control for confounders and estimate the effect of SCD on the outcomes.ResultsA total of 1,792 patients with COVID-19 were included; 38 of whom were diagnosed with SCD as well. In the SCD group, one (2.6%) patient required NIV/HFNC, one (2.6%) required MV and one (2.6%) death occurred. In comparison, 56 (3.2%) of the non-SCD patients required NIV/HFNC, 47 (2.7%) required MV and death occurred in 58 (3.3%) patients. Upon adjusting for confounders, SCD had an odds ratio of 1.847 (95% CI: 0.39 – 8.83; p=0.442).ConclusionOur results indicate that SCD is not a risk factor for worse disease outcomes in COVID-19 patients.

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COVID-19 in patients with sickle cell disease - a case series from a UK Tertiary Hospital

Cited by 34 publications

References 5 publications

Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection

Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection

Hemoglobinopathy and pediatrics in the time of COVID-19

Is sickle cell disease a risk factor for severe COVID-19 : a multicenter national retrospective cohort

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