Hemoglobinopathy and pediatrics in the time of COVID-19

Abstract

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.

COVID-19 Mortality in a Pediatric Patient with Hemoglobin SC Disease and Alpha-Thalassemia Trait

“…ACS in a pediatric patient does not necessarily portend a poor outcome [ 13 , 14 ]. Subsequent data have challenged the notion that sickle cell disease is protective [ 15 , 16 ]. Genetic data suggests that sickle cell disease may be a risk factor for COVID-19 pneumonia [ 17 ].…”

O papel da extensão universitária no contexto da pandemia de COVID-19 para famílias com crianças e adolescentes portadores de doença falciforme: relato de experiência

“…Somado a isso, com o advento da pandemia da COVID-19, essa população demanda ainda mais cuidado, uma vez que a infecção pelo Sars-CoV-2 é recente e carece de estudos e dados para se determinar os potenciais riscos da sua gravidade nessa população (Elia et al, 2021). A literatura tem demonstrado concomitância da infecção por Sars-CoV-2 com quadros de crises vasooclusivas e/ou de síndrome torácica aguda (Vilela et al, 2021).…”

Differences between children with severe acute lower respiratory infection with or without SARS-Cov-2 infection

“…A recently published review pointed out that pediatric SCD patients with SARS-CoV-2 infection need more intensive care that the global pediatric population. 8 It means that as soon as COVID-19 vaccination is approved for the pediatric population, children with SCD should be in high priority groups.…”