Presentation, management, and outcomes of COVID‐19 in patients with sickle cell disease

Anusim, Nwabundo; Gupta, Ruby; Ahaneku, Hycienth; Franklin, Candace; Balaraman, Savitha; Huben, Marianne Terese; Jaiyesimi, Ishmael

doi:10.1002/jha2.162

Cited by 7 publications

(8 citation statements)

References 6 publications

(6 reference statements)

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“…It is also possible that certain pathophysiological characteristics of SCD provide protective effects from fatal COVID-19 disease [ 57 ]. In line with this idea, some case studies reported that those with milder hemoglobin genotype had worse outcomes [ 43 , 58 ], although this could also be explained by a lack of hydroxyurea treatment associated with milder genotypes, which may have contributed to unfavorable outcomes. It has been recently demonstrated by proteomic analysis that neutrophils in patients with SCD present an unexpected activation of the interferon-α signaling pathway [ 59 ].…”

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 98%

“… n/a 0 (0) André et al [ 79 ] France 1 (0/1) 5 n/a n/a ICU admission for rapid respiratory degradation after initial phase with mild symptoms. n/a 0 (0) Anusim et al [ 43 ] USA 11 (4/7) 44 HbSS (5), HbSC (4), HbSβ + (1), HbSα (1) BT (5) Pt presentations varied from mild to severe; Older age/milder genotypes had worse outcomes; ACS and COVID-19 pneumonia present similarly and should be differentiated before treatment. 10 (91) 2 (18) Appiah-Kubi et al [ 80 ] USA 7 (2/5) 14 HbSS (6), HbSC (1) HU (4) BT (1) One ICU stay, no intubations.…”

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

“…Case studies show even higher hospitalization trends, although this may be in part due to patient selection bias. Of the 9 case studies that reported both hospitalized and non-hospitalized patients, the COVID-19-related hospitalization rate for persons with SCD was 72% (44/61) [ [42] , [43] , [44] , [45] , [46] ].…”

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

“…Among case studies, nearly all studies reported favorable outcomes, regardless of disease course. In 3 case studies, there were 4 deaths (all adults) out of 121 individuals with SCD [ 43 , 54 , 55 ], which represents 3.3% mortality rate.…”

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

“…Furthermore, because of marked differences in disease severity between different sickle genotypes, COVID-19 outcomes may vary between sickle cell patients. Interestingly, various studies observed that genotypes associated with milder SCD (i.e., HbSC, HbSE, HbSβ + ) had no different or worse outcomes than genotypes associated with more severe SCD (i.e., HbSS, HbSβ 0 ) [ 27 , 30 , 32 , 43 , 58 ]. We speculate that sickle cell anemia-specific therapies or pathophysiology, such as activation of the interferon-α signaling pathway as discussed earlier in this work, may provide a protective effect against COVID-19, but the reasons for this observation are unknown and require further investigation.…”

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

See 4 more Smart Citations

Clinical outcomes of COVID-19 in patients with sickle cell disease and sickle cell trait: A critical appraisal of the literature

et al. 2022

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Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 98%

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

Section: Patients With Covid-19 and Sickle Cell Diseasementioning

confidence: 99%

See 3 more Smart Citations

Clinical outcomes of COVID-19 in patients with sickle cell disease and sickle cell trait: A critical appraisal of the literature

et al. 2022

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Presentation, management, and outcomes of COVID‐19 in patients with sickle cell disease

Anusim

Gupta

Ahaneku

et al. 2021

eJHaem

Self Cite

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Sickle cell disease and coronavirus disease-2019 (COVID-19) infection: a single-center experience

Devarashetty

Grewal

Blanc

et al. 2023

Postgraduate Medical Journal

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Purpose Sickle cell disease (SCD) has been found to be associated with an increased risk of hospitalization and death from coronavirus disease-2019 (COVID-19). We sought to study clinical outcomes in patients with SCD and a diagnosis of COVID-19 infection. Methods We conducted a retrospective analysis of adult patients (>18 years) with SCD who were diagnosed with COVID-19 infection between 1 March 2020 and 31 March 2021. Data on baseline characteristics and overall outcomes were collected and analyzed using SAS 9.4 for Windows. Results A total of 51 patients with SCD were diagnosed with COVID-19 infection in the study period, out of which 39.3% were diagnosed and managed in the outpatient setting/emergency room (ER) and 60.3% in the inpatient setting. Disease-modifying therapy such as hydroxyurea did not impact inpatient vs outpatient/ER management (P > 0.05). Only 5.71% (n = 2) required intensive care unit admission and were mechanically ventilated and 3.9% (2 patients) died of complications of COVID-19 infection. Conclusion We identified a lower mortality (3.9%) rate among patients in our cohort in comparison to previous studies and a higher burden of inpatient hospitalizations as compared to outpatient/ER management. Further prospective data are needed to validate these findings. Key messages What is already known on this topic COVID-19 has been shown to have a disproportionately unfavorable impact on African Americans, including longer hospital stays, higher rates of ventilator dependence, and a higher overall mortality rate. Limited data also suggest that sickle cell disease (SCD) is associated with an increased risk of hospitalization and death from COVID-19. What this study adds Our analysis did not show a higher mortality due to COVID-19 in patients with SCD. However, we identified a high burden of inpatient hospitalizations in this population. COVID-19-related outcomes did not improve with the use of disease-modifying therapies. How this study might affect research, practice, or policy These results will aid in decision making for triage of patients with COVID-19 and SCD and ensure the most appropriate use of healthcare resources. Our analysis underscores the need for more robust data to identify patients at higher risk of severe disease and/or mortality, necessitating inpatient hospitalization and aggressive management.

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Presentation, management, and outcomes of COVID‐19 in patients with sickle cell disease

Cited by 7 publications

References 6 publications

Clinical outcomes of COVID-19 in patients with sickle cell disease and sickle cell trait: A critical appraisal of the literature

Clinical outcomes of COVID-19 in patients with sickle cell disease and sickle cell trait: A critical appraisal of the literature

Presentation, management, and outcomes of COVID‐19 in patients with sickle cell disease

Sickle cell disease and coronavirus disease-2019 (COVID-19) infection: a single-center experience

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