Impact of COVID-19 on vasooclusive crisis in patients with sickle cell anaemia

Abstract

Objectives The aim of this study was to assess the impact of COVID-19 on the morbidity and mortality on vasooclusive crisis (VOC) in sickle cell anaemia (SCA) patients. Methods One hundred patients with(fifty) or without COVID-19 PCR positivity(fifty), were enrolled in a prospective cohort study after signing a written informed consent. Results The COVID-19 positive patients had significantly higher median VOC episodes/year i.e 3 /year (IQR, 1-6 /year) v/s 2 /year (IQR, 2-12 /year) (p < 0.05) respectively, however the need for hospitalization was similar. There was a higher culture proven infection in COVID-19 negative group (P = 0.05). COVID-19 positive group had more osteonecrosis (p < 0.05), splenic sequestration, splenomegaly, and hepatic crisis (P values 0.05, 0.006 and 0.02 respectively). Symptoms of fever, cough, fatigue, abdominal pain and anosmia were significantly higher (p < 0.05) in the COVID-19 positive patients. Both cohorts, showed a fall in the mean haemoglobin, lymphocyte subset, platelets, and reticulocytes, whereas, the LDH and ferritin were significantly elevated. In SCA COVID-19 positive patients the rise in WBC, reticulocyte%, platelets, and ferritin was subdued (p < 0.05). Two died in COVID-19 positive, whereas three died in the COVID-19 negative, without statistically significant difference in mortality. Conclusions Although COVID-19 infection may have triggered the onset of VOC, it did not significantly influence the morbidity or mortality in this SCA cohort.

Individuals with sickle cell disease and sickle cell trait demonstrate no increase in mortality or critical illness from COVID-19 - a fifteen hospital observational study in the Bronx, New York

“…Similarly, Alkindi et al 14 reported COVID-19 infection may have triggered the onset of VOC, but it did not significantly influence the morbidity or mortality of SCD patients. The Bronx was disproportionally impacted by the first wave of COVID-19 with more hospitalizations and deaths than any other NYC borough, 15 which may explain the high mortality (11%) in our non-SCD population.…”

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

“…with COVID-19 required admission to the ICU. n/a n/a n/a n/a Alkindi et al [ 26 ] Oman 50 (27/23) 31 HbSS (10), HbSβ 0 (29), Unknown (11) BT (26) SCD w/o COVID-19 Although COVID-19 may trigger VOC onset, it does not increase mortality compared to non-COVID-19 pts. with VOC.…”

“…Adult SCD patients typically experience mild to moderate COVID-19-related symptoms [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] ], which is characterized by few respiratory symptoms and not requiring intensive care unit (ICU) admission. Large US registry studies found that approximately 80% of adult SCD patients experience mild to moderate symptoms (or no symptoms at all) [ 29 , 30 ] and that the type of COVID-19-related symptoms, including cough/fever or more severe symptoms such as respiratory failure, were not different from patients without SCD [ 33 ].…”

Safety warning for ChAdOx1 nCov-19 vaccine in patients with sickle cell disease

“…It is also important to note that although mortality in patients with SCD who had COVID-19 was slightly higher than that of the general population, our own experience with COVID-19 related illness in SCD was generally of a mild to moderate in severity. 7 …”