SARS‐CoV‐2 omicron variant may present with severe sickle cell painful crisis: A report of two cases

Abstract

Coronavirus disease 2019 (COVID‐19) is a respiratory viral illness that is caused by coronavirus 2 (SARS‐CoV‐2). The disease often presents with non‐specific symptoms such as fever, headache, and fatigue, accompanied by respiratory symptoms (e.g., cough and dyspnea) and other systemic involvement. Currently, the virus had shown significant changes and mutations that resulted in the emergence of different strains. Each strain varies in its virulence, disease severity, and the response of the body's immune system. Sickle cell disease characterized by hemolytic anemia particularly in associated with stress. Patients with sickle cell disease infected with SARS‐CoV‐2 are reported to have increased risk for hospitalization, thrombosis, and other complications compared with non‐sickle cell patients. The Omicron variant causes mild disease in general population; however, in patients with sickle cell disease, the data are limited. We present two patients known to have sickle cell disease presented with a severe acute painful crisis that required hospitalization after infection with Omicron variant of the SARS‐CoV‐2 virus.

SARS-CoV-2 with Influenza B Coinfection in a Patient with Sickle Cell HbSC Presenting with Painful Crisis: A Case Report

“…First, viral-related factors: infection with mild strain could result in mild disease. For example, omicron virus infection is reported to cause mild disease in patients with sickle cell anemia [12]; this is not only in sickle cell anemia but also in other hematologic diseases like myeloproliferative neoplasms and chronic lymphocytic leukemia [13][14][15][16]. Second, host-related factors, such as the young age and the absence of comorbid medical conditions, are usually associated with lower morbidity and a better outcome.…”

Impact of the SARS-CoV-2 infection in individuals with sickle cell disease: an integrative review

“…Clift et al ( 40 ) demonstrated a 2- to 4-fold increased risk of hospitalization for people with sickle cell disease and COVID-19 and an enhanced risk of death from the infection up to 2.6-fold in this population. Some reports have pointed out that the increased risks for poorer outcomes in this group remain even in the presence of novel variants of the virus, among vaccines, and among children, which are situations associated with less severe clinical presentations in the general public ( 95 , 96 , 118 ). In some cases, even individuals with sickle cell trait are considered to be at risk ( 40 , 110 , 112 , 119 ).…”

“…These manifestations have been reported since the beginning of the pandemic with significant frequency, although the cause-effect correlation cannot always be clearly determined. There are points of disagreement about the biological impact of COVID-19 in individuals with sickle cell disease, but most authors seem to agree that SARS-CoV-2 can act as a trigger for vaso-occlusive crises and acute chest syndrome ( 14 , 29 , 30 , 32 , 34 , 37 , 39 , 42 , 43 , 45 , 46 , 67 , 71 , 72 , 74 , 75 , 77 , 79 , 82 , 84 , 86 , 90 , 92 , 98 , 104 , 106 , 109 , 112 , 118 ). Explanations for this are grounded in empirical data and well-established knowledge about the mechanisms by which infections trigger complications of sickle cell disease.…”