COVID-19 and Sickle Cell Disease in the Province of Quebec, Canada: Outcomes after Two Years of the Pandemic

Abstract

Background: Patients with sickle cell disease (SCD) are considered at higher risk of severe COVID-19 infection. However, morbidity and mortality rates are variable among countries. To date, there are no published reports that document outcomes of SCD patients with COVID-19 in Canada. Methods: A web-based registry was implemented in June 2020 capturing outcomes of SCD patients with COVID-19 from March 2020 to April 2022 and comparing them to the general population of Quebec, Canada. Results: After 24 months of the pandemic, 185 SCD patients with confirmed SARS-CoV-2 infection were included in the registry. Overall, the population was young (median age 12 years old) and had few comorbidities. No deaths were reported. Risk of hospitalization and admission to intensive care unit (ICU) because of COVID-19 was higher in patients with SCD than in the general population (relative risks (RR) 5.15 (95% confidence interval (95% CI) 3.84–6.91), p ˂ 0.001 and 4.56 (95% CI 2.09–9.93) p ˂ 0.001). A history of arterial hypertension or acute chest syndrome in the past 12 months was associated with a higher risk of severe disease (RR = 3.06 (95% CI 1.85–5.06) p = 0.008 and 2.27 (95% CI 1.35–3.83) p = 0.01). Hospitalized patients had lower hemoglobin F than non-hospitalized patients (12% vs. 17%, p = 0.02). For those who had access to vaccination at the time of infection, 25 out of 26 patients were adequately vaccinated and had mild disease. Conclusions: The SCD population is at higher risk of severe disease than the general population. However, we report favorable outcomes as no deaths occurred. Registries will continue to be critical to document the impact of novel COVID-19 specific therapy and vaccines for the SCD population.

Impact of COVID‐19 on incidence, clinical presentation, and prognosis of acute chest syndrome in patients with sickle cell disease

“…A prior history of recent ACS was associated with a higher risk of severe disease. However it was reported favorable outcomes as no deaths occurred [21]. In our series, only one death was registered in SCD patients hospitalized for ACS during the pandemic period, and was not due to COVID‐19.…”

Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital

“…Given the morbidity observed within our SCD cohort of children and adolescents, COVID-19 vaccination within this age group may prove beneficial in reducing unwanted SCD complications and hospitalizations. Additional end-organ damage resulting from an acute COVID-19 infection in SCD within the 1st two decades of life is unknown but may contribute to future SCD morbidity in an infection that has already exhibited subacute and chronic complications in the form of Long COVID-19 syndrome (31).…”

Assessing the Impact of COVID-19 Vaccines on Sickle Cell Anaemia Patients: A Comparative Analysis of Biochemical and Haematological Parameters

“…Recent studies have shown that individuals with SCD who contract COVID-19 are more likely to experience severe symptoms, require hospitalization, and they are at a higher mortality risk than the general population [ 22 , 23 ]. Previous studies have shown that adults with SCD usually have mild to moderate COVID-19 disease but are at higher risk of COVID-19-related hospitalization and death compared to adults without SCD [ 21 , 24 , 25 ]. Most children with SCD and COVID-19 infection encounter mild illness; however, those with sickle cell anemia (SCA)-related comorbidities are more likely to require hospitalization [ 26 ].…”