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Devarashetty SP, Grewal US, Le Blanc K, Walton J, Jones T, Shi R, Master SR, Mansour RP, Ramadas P. Sickle cell disease and coronavirus disease-2019 (COVID-19) infection: a single-center experience. Postgrad Med J 2023; 99:1008-1012. [PMID: 37399057 DOI: 10.1093/postmj/qgad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 07/04/2023]
Abstract
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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Affiliation(s)
- Sindhu P Devarashetty
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Udhayvir S Grewal
- Division of Internal Medicine, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Kimberly Le Blanc
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Jacqueline Walton
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Tabitha Jones
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Runhua Shi
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Samip R Master
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Richard P Mansour
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
| | - Poornima Ramadas
- Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, United States
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Pereira LRG, da Silva MVG, Germano CMR, Estevao IF, Melo DG. Impact of the SARS-CoV-2 infection in individuals with sickle cell disease: an integrative review. Front Med (Lausanne) 2023; 10:1144226. [PMID: 37200963 PMCID: PMC10187638 DOI: 10.3389/fmed.2023.1144226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
Sickle cell disease is the most common hemoglobinopathy among humans. As the condition promotes susceptibility to infections, chronic inflammation, and hypercoagulability disorders, several international agencies have included individuals with this disease in the COVID-19 risk group for severe outcomes. However, available information about the subject is not properly systematized yet. This review aimed to understand and summarize the scientific knowledge about the impact of SARS-CoV-2 infection in patients with sickle cell disease. Searches were performed in the Medline, PubMed, and Virtual Health Library databases based on descriptors chosen according to the Medical Subject Headings. We analyzed studies published between 2020 and October 2022, developed with qualitative, quantitative, or mixed methodology, and written in English, Spanish, or Portuguese. The search resulted in 90 articles organized into six categories. There is disagreement in the literature about how different aspects related to sickle cell disease, such as chronic inflammation status, hypercoagulability, hemolytic anemia, use of hydroxyurea, and access to medical care interference with the clinical course of COVID-19. These topics deserve further investigation. It is evident, however, that the infection may manifest in an atypical way and act as a trigger for the development of sickle cell-specific complications, such as acute chest syndrome and vaso-occlusive crises, conditions that are associated with great morbidity and mortality. Therefore, healthcare professionals must be aware of the different forms of presentation of COVID-19 among these individuals. Specific guidelines and therapeutic protocols, as well as public policies for sickle cell individuals, must be considered. Systematic review registration This review (https://doi.org/10.17605/OSF.IO/NH4AS) and the review protocol (https://osf.io/3y649/) are registered in the Open Science Framework platform.
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Affiliation(s)
| | | | | | | | - Débora Gusmão Melo
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, Brazil
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3
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Calderwood S, Sabir A, Rao L, Baker B, Balasa V, Sathi BK. SARS-CoV-2 Infection Presenting as Acute Chest Syndrome in a Child With Hemoglobin SD-Los Angeles Disease: A Case Report and Review of Literature. J Pediatr Hematol Oncol 2023; 45:82-87. [PMID: 36162052 DOI: 10.1097/mph.0000000000002546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 07/29/2022] [Indexed: 11/26/2022]
Abstract
Hemoglobin D-Los Angeles is a variant of hemoglobin that can polymerize in the deoxygenated state. When co-inherited with Hemoglobin S (HbSD-Los Angeles disease) a severe sickling syndrome similar to HbSS can result. Corona virus infectious disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome-corona virus-2. It has been associated with acute chest syndrome (ACS) in individuals with sickle cell disease (SCD), but this complication has not previously been reported in patients with HbSD-Los Angeles. Dexamethasone has been shown to improve outcomes in non-SCD patients with severe acute respiratory syndrome-corona virus-2 pneumonia or acute respiratory distress syndrome; however, its use in SCD patients with ACS is controversial due to a reported increased risk of complications including vaso-occlusive painful episodes. Herein, we reported a patient with HbSD-Los Angeles and COVID-19-associated ACS whom we treated with dexamethasone without transfusion. The patient experienced a rapid recovery without sequelae from steroid use. To further evaluate the use of steroids, we conducted a literature review focusing on the management of pediatric SCD patients with COVID-19-associated ACS. We identified a total of 39 pediatric patients with SCD and COVID-19, of whom 21 (54%) had ACS. Packed red blood cell transfusion (n=11), exchange transfusion (n=4), or a combination of exchange transfusion and packed red blood cell transfusion (n=4) were the most frequently reported treatment, with hydroxychloroquine (n=5), remdesivir (n=1), and tocilizumab (n=1) also being reported. Three patients were treated with dexamethasone. All patients recovered and no adverse outcomes from steroid use were reported. Even though transfusion is considered the standard of care for children with ACS and steroids are not routinely recommended, our experience suggested that COVID-19-associated ACS may be an important exception, especially for patients who refuse transfusion or are in resource-poor nations where blood transfusions may not be readily available. Further studies are warranted to confirm these observations.
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Affiliation(s)
- Stanley Calderwood
- Pediatric Hospital Medicine Program, Bakersfield Memorial Hospital, Bakersfield
- Valley Children's Healthcare, Madera
| | - Aqsa Sabir
- Pediatric Hospital Medicine Program, Bakersfield Memorial Hospital, Bakersfield
- Valley Children's Healthcare, Madera
| | - Latha Rao
- Pediatric Hematology Oncology
- Valley Children's Healthcare, Madera
| | | | - Vinod Balasa
- Pediatric Hematology Oncology
- Valley Children's Healthcare, Madera
- University of San Francisco-Fresno Program, Fresno, CA
| | - Bindu K Sathi
- Pediatric Hematology Oncology
- Valley Children's Healthcare, Madera
- University of San Francisco-Fresno Program, Fresno, CA
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4
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Elia GM, Konstantyner T, Nais RP, Santos ARAD, Angel A, Braga JAP. Clinical and laboratory differences between pediatric hospitalized patients with sickle cell disease infected or not by SARS-CoV-2. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2021407. [PMID: 36921171 PMCID: PMC10013992 DOI: 10.1590/1984-0462/2023/41/2021407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/08/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The aim of this study was to identify clinical and complete blood count differences between pediatric hospitalized patients with sickle cell disease infected or not by SARS-CoV-2 and compare the complete blood count of patients with sickle cell disease infected by SARS-CoV-2 before hospitalization and on admission. METHODS This study was a single-center prospective cohort. Data were collected from medical records of pediatric inpatients with sickle cell disease under 18 years old infected or not with SARS-CoV-2 from the first visit to the hospital until discharge and from the last medical appointment. All patients were tested for SARS-CoV-2 by the real-time reverse transcription polymerase chain reaction. RESULTS Among 57 pediatric patients with sickle cell disease hospitalized from March to November 2020 in a Brazilian academic hospital, 11 (19.3%) had a positive result for SARS-CoV-2. Patients infected by SARS-CoV-2 had a higher prevalence of comorbidities than the ones who were not infected (63.6 vs. 30.4%; p=0.046). During hospital stay, no clinical or complete blood count differences between groups were found. There was a decrease in eosinophil count on hospital admission in patients with sickle cell disease infected by SARS-CoV-2 (p=0.008). CONCLUSIONS Pediatric hospitalized patients with sickle cell disease infected by SARS-CoV-2 had more comorbidities and had a decrease in eosinophil count between hospital admission and the last medical appointment.
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Affiliation(s)
- Gabriella Mafra Elia
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Tulio Konstantyner
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | - Rafaela Pilotto Nais
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | | | - Andrea Angel
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
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Evidence-based management of pregnant women with sickle cell disease in high-income countries. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2022; 2022:408-413. [PMID: 36485166 PMCID: PMC9820817 DOI: 10.1182/hematology.2022000378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Globally, patients living with sickle cell disease are now surviving to reproductive age, with life expectancy approaching 50 years in most countries. Thus, reproductive options are now essential for patients living with the condition. However, it can be associated with maternal, delivery, and fetal complications. Outcomes may vary depending on the level of expertise and resources. In this piece we provide an optional guideline for managing sickle cell disease in pregnancy. The therapeutic option of serial exchange prophylactic transfusion has been offered in the context of a clinical trial (TAPS2).
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6
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Lubala TK, Kayembe-Kitenge T, Makinko P, Kalenga L, Kachil H, Kayembe A, Mutombo A, Shongo M. Deep venous thrombosis and acute pericarditis associated with severe acute respiratory syndrome coronavirus 2 infection in a Congolese infant with sickle cell disease: a case report. J Med Case Rep 2022; 16:307. [PMID: 35945602 PMCID: PMC9363144 DOI: 10.1186/s13256-022-03459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background Since the beginning of the pandemic, no severe pediatric coronavirus disease 2019 cases have been described in Congo. Case We studied a 3-month-old male child of Congolese origin who was admitted to the pediatric department with 7-day history of fever, unilateral lower leg swelling, and dyspnea. There was no known history of contact with a coronavirus disease 2019 patient, and all the family members were asymptomatic. Nasopharyngeal swabs done at admission did not detect severe acute respiratory syndrome coronavirus 2. However, serology tests for severe acute respiratory syndrome coronavirus 2 antibodies were positive for immunoglobulin M and negative for immunoglobulin G. Hemoglobin electrophoresis showed hemoglobin A1, hemoglobin A2, hemoglobin F, and hemoglobin S of 46.2%, 2.5%, 19.9%, and 38.4%, respectively. Chest X-ray showed retrocardiac pneumonia in the left lung, and Doppler ultrasound of the left lower limb showed a recent total femoropopliteal venous thrombosis. At day 10 of hospitalization, our patient had classical signs of cardiac tamponade with a voluminous pericardial effusion seen on echocardiographic examination and elevated C-reactive protein, compatible with a diagnosis of constrictive pericarditis. To the best of the authors’ knowledge, this is the first report of a case of plausible severe acute respiratory syndrome coronavirus 2 infection associated with venous thrombosis and acute pericarditis in Congo. Conclusion We hypothesized that this case of venous thrombosis and acute pericarditis in a Congolese child with heterozygous sickle cell disease was related to severe acute respiratory syndrome coronavirus 2 infection.
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Affiliation(s)
- Toni Kasole Lubala
- Department of Pediatrics, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.,Department of Pediatrics, CMDC Clinic, Lubumbashi, Democratic Republic of the Congo
| | - Tony Kayembe-Kitenge
- Unit of Toxicology, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo. .,High Institute of Medical Techniques (ISTM), Lubumbashi, Democratic Republic of the Congo. .,Center for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Paul Makinko
- Department of Pediatrics, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.,Department of Pediatrics, CMDC Clinic, Lubumbashi, Democratic Republic of the Congo
| | - Luguette Kalenga
- Department of Pediatrics, CMDC Clinic, Lubumbashi, Democratic Republic of the Congo
| | - Hénoch Kachil
- Department of Radiology, CMDC Clinic, Lubumbashi, Democratic Republic of the Congo
| | - Axel Kayembe
- Department of Radiology, CMDC Clinic, Lubumbashi, Democratic Republic of the Congo
| | - Augustin Mutombo
- Department of Pediatrics, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Mick Shongo
- Department of Pediatrics, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
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7
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Hoogenboom WS, Alamuri TT, McMahon DM, Balanchivadze N, Dabak V, Mitchell WB, Morrone KB, Manwani D, Duong TQ. Clinical outcomes of COVID-19 in patients with sickle cell disease and sickle cell trait: A critical appraisal of the literature. Blood Rev 2022; 53:100911. [PMID: 34838342 PMCID: PMC8605823 DOI: 10.1016/j.blre.2021.100911] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/18/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023]
Abstract
Individuals with sickle cell disease (SCD) and sickle cell trait (SCT) have many risk factors that could make them more susceptible to COVID-19 critical illness and death compared to the general population. With a growing body of literature in this field, a comprehensive review is needed. We reviewed 71 COVID-19-related studies conducted in 15 countries and published between January 1, 2020, and October 15, 2021, including a combined total of over 2000 patients with SCD and nearly 2000 patients with SCT. Adults with SCD typically have a mild to moderate COVID-19 disease course, but also a 2- to 7-fold increased risk of COVID-19-related hospitalization and a 1.2-fold increased risk of COVID-19-related death as compared to adults without SCD, but not compared to controls with similar comorbidities and end-organ damage. There is some evidence that persons with SCT have increased risk of COVID-19-related hospitalization and death although more studies with risk-stratification and properly matched controls are needed to confirm these findings. While the literature suggests that most children with SCD and COVID-19 have mild disease and low risk of death, some children with SCD, especially those with SCD-related comorbidities, are more likely to be hospitalized and require escalated care than children without SCD. However, children with SCD are less likely to experience COVID-19-related severe illness and death compared to adults with or without SCD. SCD-directed therapies such as transfusion and hydroxyurea may be associated with better COVID-19 outcomes, but prospective studies are needed for confirmation. While some studies have reported favorable short-term outcomes for COVID-19 patients with SCD and SCT, the long-term effects of SARS-CoV-2 infection are unknown and may affect individuals with SCD and SCT differently from the general population. Important focus areas for future research should include multi-center studies with larger sample sizes, assessment of hemoglobin genotype and SCD-modifying therapies on COVID-19 outcomes, inclusion of case-matched controls that account for the unique sample characteristics of SCD and SCT populations, and longitudinal assessment of post-COVID-19 symptoms.
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Affiliation(s)
- Wouter S. Hoogenboom
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA,Corresponding authors at: Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, 1300 Morris Park Avenue, Bronx, New York 10461, USA
| | - Tharun T. Alamuri
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Daniel M. McMahon
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Nino Balanchivadze
- Department of Hematology and Oncology, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Vrushali Dabak
- Department of Hematology and Oncology, Henry Ford Hospital, Detroit, MI 48202, USA
| | - William B. Mitchell
- Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Kerry B. Morrone
- Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Tim Q. Duong
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA,Corresponding authors at: Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, 1300 Morris Park Avenue, Bronx, New York 10461, USA
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8
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Mawalla WF, Nasser A, Jingu JS, Joseph H, Mmbaga LG, Shija E, Kakumbula H, Lubuva NB, Meda C, Chamba C. Acute chest syndrome and COVID‐19 in hydroxyurea naïve sickle cell disease patient in a low resource setting. EJHAEM 2022; 3:507-512. [PMID: 35602245 PMCID: PMC9110990 DOI: 10.1002/jha2.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 12/15/2022]
Abstract
Acute chest syndrome (ACS) is a severe complication of sickle cell disease (SCD) and one of the leading causes of mortality in SCD patients. The management of ACS is challenging and requires prompt intervention to halt clinical deterioration. With the outbreak of the Coronavirus Disease 2019 (COVID‐19) pandemic, which also primarily results in acute respiratory illness, the clinical picture and treatment outcome in SCD patients with ACS remain unknown. We present a case of a 30‐year‐old male who came in with features of painful vaso‐occlusive episode and haemolysis that later evolved to acute chest syndrome. Chest X‐ray showed pneumonic changes and mild bilateral pleural effusion, and nasal Reverse Transcription‐Polymerase Chain Reaction (RT‐PCR) for COVID‐19 test came out positive. He was managed supportively with simple transfusion, antibiotics, dexamethasone and oxygen support with a good clinical outcome. Presenting with non‐specific symptoms and similar respiratory symptoms and signs, the clinical picture of COVID‐19 can prove difficult to discern from that of ACS due to other causes. This report emphasizes a need for a higher index of suspicion whenever a SCD patient presents with symptoms of acute respiratory distress.
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Affiliation(s)
- William Frank Mawalla
- Department of Haematology and Blood Transfusion Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania
| | - Ahlam Nasser
- Department of Haematology and Blood Transfusion Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania
| | - James Salumu Jingu
- Department of Internal Medicine Muhimbili National Hospital Dar es Salaam Tanzania
| | - Happiness Joseph
- Department of Haematology and Blood Transfusion Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania
| | - Lilian Gasper Mmbaga
- Department of Haematology and Blood Transfusion Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania
| | - Eunice Shija
- Department of Haematology and Blood Transfusion Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania
| | - Helena Kakumbula
- Department of Internal Medicine Muhimbili National Hospital Dar es Salaam Tanzania
| | - Neema Budodi Lubuva
- Department of Internal Medicine Muhimbili National Hospital Dar es Salaam Tanzania
| | - Collins Meda
- Department of Internal Medicine Muhimbili National Hospital Dar es Salaam Tanzania
| | - Clara Chamba
- Department of Haematology and Blood Transfusion Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania
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9
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Tentolouris A, Stafylidis C, Siafarikas C, Dimopoulou M, Makrodimitri S, Bousi S, Papalexis P, Damaskos C, Trakas N, Sklapani P, Spandidos D, Georgakopoulou V. Favorable outcomes of patients with sickle cell disease hospitalized due to COVID‑19: A report of three cases. Exp Ther Med 2022; 23:338. [PMID: 35401804 PMCID: PMC8988160 DOI: 10.3892/etm.2022.11268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/11/2022] [Indexed: 11/06/2022] Open
Abstract
Sickle cell disease (SCD) is one of the most frequent and severe monogenic disorders, affecting millions of individuals worldwide. SCD represents a fatal hematological illness, characterized by veno-occlusive events and hemolytic anemia. Hemolytic anemia is caused by abnormal sickle-shaped erythrocytes, which induce parenchymal destruction and persistent organ damage, resulting in considerable morbidity and mortality. During the coronavirus disease 2019 (COVID-19) pandemic, patients with SCD were characterized as a ‘high-risk’ group due to their compromised immune system, caused by functional hyposplenism, as well as systemic vasculopathy. COVID-19 is characterized by endothelial damage and a procoagulant condition. The present study describes the clinical features, management and outcomes of 3 patients with SCD who were hospitalized due to COVID-19, who all had favorable outcomes despite the complications.
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Affiliation(s)
- Anastasios Tentolouris
- First Department of Propedeutic and Internal Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christos Stafylidis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christos Siafarikas
- First Department of Propedeutic and Internal Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Dimopoulou
- Hemοglobinopathies Reference Center, Laiko General Hospital, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, 11527 Athens, Greece
| | - Stelios Bousi
- Renal Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Pagona Sklapani
- Department of Cytology, Mitera Hospital, 15123 Athens, Greece
| | - Demetrios Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
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10
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Cai J, Chen-Goodspeed A, Idowu M. Risk and protective factors for severe COVID-19 infection in a cohort of patients with sickle cell disease. J Investig Med 2022; 70:1243-1246. [PMID: 35260481 DOI: 10.1136/jim-2021-002196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/04/2022]
Abstract
Continued investigation of comorbid conditions that increase the mortality rate of COVID-19 is necessary to provide the best care for those affected. This continued push to find answers is even more important for populations with COVID-19 comorbidities that are historically under-researched. We performed a retrospective analysis of 30 patients with sickle cell disease (SCD) who tested positive for the COVID-19 virus. An analysis of each patient's history of SCD complications, hydroxyurea usage, comorbidities, and several other factors was performed to identify the trends that will allow the practitioners to better predict the outcomes of patients with SCD before and during hospitalization for COVID-19. Through these analyses, we found that patients receiving hydroxyurea before COVID-19 infection and patients with SCD-type HbSC had significantly milder COVID-19 disease courses than those not receiving hydroxyurea or with SCD-type HbSS. A history of acute chest syndrome (ACS), a complication seen in patients with SCD, appeared to be associated with a more severe COVID-19 disease course. By creating systems to better interpret what makes a patient with SCD at high risk for a poor prognosis, practitioners are better equipped to make data-supported recommendations for prevention, risk, and treatment. These recommendations should include beginning or maintaining hydroxyurea usage in all qualifying patients with SCD, advising patients with a history of ACS to take extra precautions to prevent initial COVID-19 infection, and initiating close monitoring in the hospital for patients with HbSS and a history of ACS.
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Affiliation(s)
- Jessi Cai
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Amber Chen-Goodspeed
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Modupe Idowu
- Hematology/Oncology, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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11
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Immune Response of Adult Sickle Cell Disease Patients after COVID-19 Vaccination: The Experience of a Greek Center. J Clin Med 2022; 11:jcm11040937. [PMID: 35207208 PMCID: PMC8879313 DOI: 10.3390/jcm11040937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/03/2022] [Accepted: 02/09/2022] [Indexed: 02/06/2023] Open
Abstract
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are essential weapons to control the spread of the coronavirus disease-19 (COVID-19) pandemic and protect immunocompromised patients. With a greater susceptibility to infection, sickle cell disease (SCD) patients are considered as “high risk” patients during the current COVID-19 pandemic. In our study, we try to determine the immune response of adult SCD patients monitored at our center after the first and second dose of the qualified mRNA vaccines available and correlate them to several disease-specific markers, as well as complement activation. The results demonstrate that the levels of neutralizing antibodies (nAbs) against SARS-CoV-2 were adequate for most patients studied after the second dose and there seemed to be a certain association with complement activation. Further studies are critical to determine the durability of this immune response and the potential benefit of a third dose.
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12
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Payne AB, Schieve LA, Abe K, Hulihan M, Hooper WC, Hsu LL. COVID-19 and Sickle Cell Disease-Related Deaths Reported in the United States. Public Health Rep 2022; 137:234-238. [PMID: 35060794 DOI: 10.1177/00333549211063518] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Sickle cell disease (SCD) is associated with increased risk of poor health outcomes from respiratory infections, including COVID-19 illness. We used US death data to investigate changes in SCD-related mortality before and during the COVID-19 pandemic. We estimated annual age- and quarter-adjusted SCD-related mortality rates for 2014-2020. We estimated the number of excess deaths in 2020 compared with 2019 using the standardized mortality ratio (SMR). We found 1023 SCD-related deaths reported in the United States during 2020, of which 86 (8.4%) were associated with COVID-19. SCD-related deaths, both associated and not associated with COVID-19, occurred most frequently among adults aged 25-59 years. The SCD-related mortality rate changed <5% year to year from 2014 to 2019 but increased 12% in 2020; the sharpest increase was among adults aged ≥60 years. The SMR comparing 2020 with 2019 was 1.12 (95% CI, 1.06-1.19). Overall, 113 (95% CI, 54-166) excess SCD-related deaths occurred in 2020.
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Affiliation(s)
- Amanda B Payne
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura A Schieve
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karon Abe
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary Hulihan
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - W Craig Hooper
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lewis L Hsu
- Division of Pediatric Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
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13
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Han H, Hensch L, Tubman VN. Indications for transfusion in the management of sickle cell disease. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2021; 2021:696-703. [PMID: 34889416 PMCID: PMC8791131 DOI: 10.1182/hematology.2021000307] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The transfusion of red blood cells (RBCs) is a crucial treatment for sickle cell disease (SCD). While often beneficial, the frequent use of transfusions is associated with numerous complications. Transfusions should be offered with specific guidelines in mind. Here we present updates to the indications for transfusion of RBCs in SCD. We review recent publications and include expert perspectives from hematology and transfusion medicine. For some clinical indications, such as ischemic stroke, the role of transfusion has been well studied and can be applied almost universally. For many other clinical scenarios, the use of transfusion therapy has less conclusive data and therefore must be tailored to individual needs. We highlight the roles of RBC transfusions in preventing or mitigating neurological disease, in reducing perioperative complications, in managing acute chest syndrome, and in optimizing pregnancy outcomes in SCD. We further highlight various transfusion techniques and when each might be considered. Potential complications of transfusion are also briefly discussed.
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Affiliation(s)
- Hyojeong Han
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Lisa Hensch
- Division of Transfusion Medicine and Coagulation, Texas Children's Hospital, Houston, TX
- Department of Pathology and Immunology and Anesthesiology, Baylor College of Medicine, Houston, TX
| | - Venée N Tubman
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
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14
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Sabetkish N, Rahmani A. The overall impact of COVID-19 on healthcare during the pandemic: A multidisciplinary point of view. Health Sci Rep 2021; 4:e386. [PMID: 34622020 PMCID: PMC8485600 DOI: 10.1002/hsr2.386] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS The Coronavirus disease 2019 (COVID-19) pandemic globally changed the priorities of medical and surgical procedures. It has caused many healthcare systems to stop performing their routine screenings. Altering medical clinics to COVID-19 referral centers, lockdowns, and the public fear to refer to medical centers caused a significant reduction in the referral rate; especially in the elderly. This short review article highlights the transform in clinical practice during the post-COVID era and the need for future medical revolutions. METHODS A comprehensive literature search was separately performed by both authors. The articles published between 2019 and August 2021 were included in this study and selected according to a quality appraisal method. RESULTS We have summarized the possible corresponding changes in the diagnosis and treatment of all fields of medical care including internal medicine, surgical, and minor subcategories after the COVID-19 pandemic. We have also discussed the potential impacts of the pandemic on all these different categories and subcategories of medicine, including the outpatient setting and clinical work. We do believe that the lack of routine check-ups has led to an increase in the stage of disease in patients with a previously diagnosed problem. On the other hand, the dramatic change in the lifestyle of the population including restricted mobility and increased consumption of unhealthy food has caused metabolic syndrome and other new diseases that have not been diagnosed and properly managed. CONCLUSION Our findings revealed the urgent need for public health awareness. It indicated the need to carry out both psychological and screening approaches in the post-COVID era to not miss patients with a chronic disease and new cases who were undiagnosed during the COVID pandemic.
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Affiliation(s)
- Nastaran Sabetkish
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical CenterTehran University of Medical SciencesTehranIran
- ImmunologyAsthma and Allergy Research Institute, Tehran University of Medical SciencesTehranIran
| | - Alireza Rahmani
- Research Center for Prevention of Cardiovascular DiseaseInstitute of Endocrinology & Metabolism, Iran University of Medical SciencesTehranIran
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15
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Lee JX, Chieng WK, Lau SCD, Tan CE. COVID-19 and Hemoglobinopathies: A Systematic Review of Clinical Presentations, Investigations, and Outcomes. Front Med (Lausanne) 2021; 8:757510. [PMID: 34722593 PMCID: PMC8549676 DOI: 10.3389/fmed.2021.757510] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022] Open
Abstract
This systematic review aimed to provide an overview of the clinical profile and outcome of COVID-19 infection in patients with hemoglobinopathy. The rate of COVID-19 mortality and its predictors were also identified. A systematic search was conducted in accordance with PRISMA guidelines in five electronic databases (PubMed, Scopus, Web of Science, Embase, WHO COVID-19 database) for articles published between 1st December 2019 to 31st October 2020. All articles with laboratory-confirmed COVID-19 cases with underlying hemoglobinopathy were included. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Thirty-one articles with data on 246 patients with hemoglobinopathy were included in this review. In general, clinical manifestations of COVID-19 infection among patients with hemoglobinopathy were similar to the general population. Vaso-occlusive crisis occurred in 55.6% of sickle cell disease patients with COVID-19 infection. Mortality from COVID-19 infection among patients with hemoglobinopathy was 6.9%. After adjusting for age, gender, types of hemoglobinopathy and oxygen supplementation, respiratory (adj OR = 89.63, 95% CI 2.514-3195.537, p = 0.014) and cardiovascular (adj OR = 35.20, 95% CI 1.291-959.526, p = 0.035) comorbidities were significant predictors of mortality. Patients with hemoglobinopathy had a higher mortality rate from COVID-19 infection compared to the general population. Those with coexisting cardiovascular or respiratory comorbidities require closer monitoring during the course of illness. More data are needed to allow a better understanding on the clinical impact of COVID-19 infections among patients with hemoglobinopathy. Clinical Trial Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218200.
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Affiliation(s)
- Jun Xin Lee
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Wei Keong Chieng
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sie Chong Doris Lau
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chai Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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16
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Sayad B, Karimi M, Rahimi Z. Sickle cell disease and COVID-19: Susceptibility and severity. Pediatr Blood Cancer 2021; 68:e29075. [PMID: 34061431 PMCID: PMC8209850 DOI: 10.1002/pbc.29075] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 12/25/2022]
Abstract
We surveyed published papers and an international sickle cell disease (SCD) registry to detect susceptibility and clinical course of coronavirus disease 2019 (COVID-19) in SCD patients. COVID-19 presentation was mild in children and moderate in many SCD adults. Regarding increased comorbidities with age, it seems severe COVID-19 to be more common in older SCD patients. Although the overall outcome of COVID-19 was favorable in SCD children, a high rate of pediatric intensive care unit admission should be considered in managing these patients. To explain COVID-19 outcome in SCD patients, the possible benefits of hydroxyurea therapy could be considered. The obtained results should be interpreted, considering low cases from sub-Saharan people, younger age of SCD patients compared to general population, a bias toward registry of the more severe form of disease, the effect of pre-existing comorbidities with multisystem organ damage, and the role of health socio-economic determinants.
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Affiliation(s)
- Babak Sayad
- Infectious Diseases Research CenterKermanshah University of Medical SciencesKermanshahIran
| | - Mehran Karimi
- Hematology Research CenterShiraz University of Medical SciencesShirazIran
| | - Zohreh Rahimi
- Department of Clinical Biochemistry, Medical SchoolKermanshah University of Medical SciencesKermanshahIran,Medical Biology Research CenterKermanshah University of Medical SciencesKermanshahIran
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17
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Nguyen V, Alcius P, Peles S, Hodgin K. A Fresh Breath of Oxygen: Red Blood Cell Exchange Transfusion in Sickle Cell and COVID-19. Clin Case Rep 2021; 9:e04655. [PMID: 34466242 PMCID: PMC8385183 DOI: 10.1002/ccr3.4655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/20/2021] [Accepted: 07/05/2021] [Indexed: 12/19/2022] Open
Abstract
Red blood cell exchange transfusion may be beneficial and should be considered in the early management of patients with sickle cell disease and COVID-19 to prevent the need for intubation and intensive care unit admission due to respiratory distress.
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Affiliation(s)
| | | | - Shachar Peles
- Florida Cancer Specialists & Research InstituteLake WorthFLUSA
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18
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Tremblay D, Rapp JL, Alpert N, Lieberman‐Cribbin W, Mascarenhas J, Taioli E, Ghaffari S. Mild anemia as a single independent predictor of mortality in patients with COVID-19. EJHAEM 2021; 2:319-326. [PMID: 34226904 PMCID: PMC8242891 DOI: 10.1002/jha2.167] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
The coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led to an unprecedented international health crisis. COVID-19 clinical presentations cover a wide range from asymptomatic to severe illness and death. Given the limited therapeutic resources and unexpected clinical features of the disease, readily accessible predictive biomarkers are urgently needed to improve patient care and management. We asked the degree to which anemia may influence the outcome of patients with COVID-19. To this end, we identified 3777 patients who were positively diagnosed with COVID-19 between March 1 and April 1 2020 in New York City. We evaluated 2,562 patients with available red blood cell, hemoglobin, and related laboratory values. Multivariable cox proportional hazards regression showed that anemia was a significant independent predictor of mortality (hazard ratio (HR): 1.26, 95% Confidence Interval [CI]: 1.06-1.51), independent of age, sex, and comorbidities. There was a direct correlation between the degree of anemia and the risk of mortality when hemoglobin was treated as a continuous variable (HRadj 1.05; [CI]: 1.01-1.09). The hemoglobin level that was maximally predictive of mortality, was 11.5 g/dL in males and 11.8 g/dL in females. These findings identify a routinely measured biomarker that is predictive of disease outcomes and will aid in refining clinical care algorithms and optimize resource allocation. Mechanisms of impacts of anemia on COVID-19 outcome are likely to be multiple in nature and require further investigation.
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Affiliation(s)
- Douglas Tremblay
- Department of MedicineDivision of Hematology OncologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Joseph L. Rapp
- Institute for Translational EpidemiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Naomi Alpert
- Institute for Translational EpidemiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Wil Lieberman‐Cribbin
- Institute for Translational EpidemiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - John Mascarenhas
- Department of MedicineDivision of Hematology OncologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Emanuela Taioli
- Institute for Translational EpidemiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Saghi Ghaffari
- Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Cell, Developmental & Regenerative BiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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19
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Oliveira PPD, Gesteira ECR, Souza RLD, Paula NCPD, Santos LC, Santos WJD, Silveira EAAD. Educational technology on COVID-19 for families of children and adolescents with sickle cell disease. Rev Bras Enferm 2021; 74:e20201045. [PMID: 34133544 DOI: 10.1590/0034-7167-2020-1045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/07/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE to construct and validate educational technology on COVID-19 and essential care for families of children/adolescents with sickle cell disease. METHODS this is a methodological study, in three stages: 1) elaborated educational technology, using the Doak, Doak and Root theoretical-methodological model; 2) content and appearance validation by the content validity coefficient. Delphi technique was applied in two rounds (Delphi I [12 judges]/Delphi II [11 judges]); 3) conducting a pilot test with six families. RESULTS "Sickle cell disease and COVID-19: essential care" included: consequences of COVID-19 in sickle cell disease, guidelines for reducing the risks of contracting the virus and having complications, signs and symptoms of COVID-19, guidelines in case of child/adolescent with suspicion or symptoms of COVID-19. Global content validity coefficient (Delphi II): 0.98. CONCLUSION educational technology presented content and appearance validity for families of children/adolescents with sickle cell disease, related to COVID-19.
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20
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Sookaromdee P, Wiwanitkit V. COVID-19 and Tropical Infection: Complexity and Concurrence. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:333-341. [PMID: 33973187 DOI: 10.1007/978-3-030-63761-3_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
COVID-19 is a newly emerging pandemic caused by a novel coronavirus. After its first report in China in December 2019, the disease already spread and affected more than 200 countries worldwide. It correlates with different phenotypes ranging from an acute febrile illness to severe respiratory problems. Often, patients with COVID-19 suffer from metabolic disorders, and this can result in a more severe clinical course. COVID-19 might also co-occur with other common diseases in different settings. In tropical countries, COVID-19 has already affected thousands of local populations. Tropical diseases such as dengue and tuberculosis can modify the clinical presentation of COVID-19 and result in difficulty in the diagnosis and treatment of the patients. The complexity of concurrence between COVID-19 and tropical diseases is, thus, a matter of concern in tropical medicine. This chapter is devoted to discussing problems surrounding the management of COVID-19 in tropical countries. To exemplify the effects of COVID-19 on tropical countries, the authors would show how COVID-19 has affected Indochina, a large tropical area.
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Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Community Medicine, Dr. DY Patil University, Pune, India. .,Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Pune, India.
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21
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Chen-Goodspeed A, Idowu M. COVID-19 Presentation in Patients with Sickle Cell Disease: A Case Series. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e931758. [PMID: 33941758 PMCID: PMC8105741 DOI: 10.12659/ajcr.931758] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Case series Patients: Male, 30-year-old • Male, 30-year-old • Male, 49-year-old • Male, 23-year-old • Female, 25-year-old Final Diagnosis: Sickle cell anemia • sickle cell disease Symptoms: Chest pain • congestion • cough • dyspnea • fever • flank pain • vasoocclusive crisis Medication: — Clinical Procedure: — Specialty: Hematology
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Affiliation(s)
| | - Modupe Idowu
- Department of Internal Medicine, Division of Hematology, University of Texas Health Science Center, Houston, TX, USA
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22
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Skariyachan S, Gopal D, Muddebihalkar AG, Uttarkar A, Niranjan V. Structural insights on the interaction potential of natural leads against major protein targets of SARS-CoV-2: Molecular modelling, docking and dynamic simulation studies. Comput Biol Med 2021; 132:104325. [PMID: 33751995 PMCID: PMC7954774 DOI: 10.1016/j.compbiomed.2021.104325] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 12/16/2022]
Abstract
Though significant efforts are in progress for developing drugs and vaccines against COVID-19, limited therapeutic agents are available currently. Thus, it is essential to undertake COVID-19 research and to identify therapeutic interventions in which computational modeling and virtual screening of lead molecules provide significant insights. The present study aimed to predict the interaction potential of natural lead molecules against prospective protein targets of SARS-CoV-2 by molecular modeling, docking, and dynamic simulation. Based on the literature survey and database search, fourteen molecular targets were selected and the three targets which lack the native structures were computationally modeled. The drug-likeliness and pharmacokinetic features of ninety-two natural molecules were predicted. Four lead molecules with ideal drug-likeliness and pharmacokinetic properties were selected and docked against fourteen targets, and their binding energies were compared with the binding energy of the interaction between Chloroquine and Hydroxychloroquine to their usual targets. The stabilities of selected docked complexes were confirmed by MD simulation and energy calculations. Four natural molecules demonstrated profound binding to most of the prioritized targets, especially, Hyoscyamine and Tamaridone to spike glycoprotein and Rotiorinol-C and Scutifoliamide-A to replicase polyprotein-1ab main protease of SARS-CoV-2 showed better binding energy, conformational and dynamic stabilities compared to the binding energy of Chloroquine and its usual target glutathione-S-transferase. The aforementioned lead molecules can be used to develop novel therapeutic agents towards the protein targets of SARS-CoV-2, and the study provides significant insight for structure-based drug development against COVID-19.
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Affiliation(s)
- Sinosh Skariyachan
- Department of Microbiology, St. Pius X College Rajapuram, Kasaragod, Kerala, India,Corresponding author
| | - Dharshini Gopal
- Department of Bioinformatics, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Akshay Uttarkar
- Department of Biotechnology, RV College of Engineering, Bengaluru, Karnataka, India
| | - Vidya Niranjan
- Department of Biotechnology, RV College of Engineering, Bengaluru, Karnataka, India
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23
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COVID-19 Mortality in a Pediatric Patient with Hemoglobin SC Disease and Alpha-Thalassemia Trait. Case Rep Crit Care 2021; 2021:6617362. [PMID: 34007491 PMCID: PMC8080871 DOI: 10.1155/2021/6617362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/21/2021] [Accepted: 04/20/2021] [Indexed: 12/19/2022] Open
Abstract
As the pandemic continues to evolve, more cases of COVID-19 in pediatric patients are being detected. A 12-year-old boy with HbSC disease alpha-thalassemia trait presented to a pediatric emergency room with fever and weakness. His vital signs were notable for fever, tachypnea, and tachycardia. His physical exam was concerning for increased work of breathing. He tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by PCR although his hemoglobin level remained near his baseline. His chest radiograph showed a retrocardiac opacity concerning for evolving acute chest syndrome. He decompensated quickly requiring invasive mechanical ventilation and exchange transfusion. He received hydroxychloroquine, broad-spectrum antibiotics, and enoxaparin for DVT prophylaxis. Despite showing clinical signs of improvement, he became acutely hypoxemic and suffered a cardiac arrest. We believe this to be an unusual case of a pediatric patient with HbSC disease and COVID-19. We outline clearly the course of illness and treatments trialed, which can prove beneficial to providers facing similar challenges as this virus continues to strike areas around the world. Although children have significantly better outcomes than adults, providers must remain vigilant while treating any patient with a hemoglobinopathy in the setting of severe COVID-19.
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24
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Alkindi S, Elsadek RA, Al-Madhani A, Al-Musalhi M, AlKindi SY, Al-Khadouri G, Al Rawahi B, Al-Ruqeishi S, Al-Yazeedi J, Wali YA, Al Shamakhi S, Al Rawahi M, Pathare AV. Impact of COVID-19 on vasooclusive crisis in patients with sickle cell anaemia. Int J Infect Dis 2021; 106:128-133. [PMID: 33741487 PMCID: PMC7962915 DOI: 10.1016/j.ijid.2021.03.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives The study aimed to assess COVID-19 impact on the morbidity and mortality of vasooclusive crisis (VOC) in sickle cell anaemia (SCA) patients. Methods A prospective cohort study of 100 SCA patients; 50 with COVID-19 (COVID group) and 50 without (non-COVID group). All patients signed written informed consent. Results The COVID group had a significantly higher VOC episode median per year; 3 (IQR,1-6) vs 2 (IQR,2-12) (P < 0.05). The need for hospitalisation was similar in both groups. The non-COVID group had more history of culture-proven infection (P = 0.05). The COVID-group had more osteonecrosis (P < 0.05), splenic sequestration, splenomegaly and hepatic crisis (P = 0.05, 0.006, 0.02; respectively) and significantly higher (P < 0.05) symptoms of fever, cough, fatigue, abdominal pain and anosmia. Mean haemoglobin, lymphocyte subset, platelets, and reticulocytes were reduced in both groups, while lactate dehydrogenase and ferritin levels were significantly elevated. In the COVID group, the rise in white blood cell count, reticulocyte percentage, platelets and ferritin was subdued (P < 0.05). Two patients in the COVID group and 3 in the non-COVID group died; there was no statistically significant difference in mortality. Conclusions Although COVID-19 may have triggered the onset of VOC, it did not significantly influence VOC-related morbidity or mortality in this SCA cohort.
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Affiliation(s)
- S Alkindi
- Department of Haematology, Sultan Qaboos University Hospital, Oman; College of Medicine and Health Sciences, Muscat, Oman.
| | - R A Elsadek
- Department of Medicine-Nizwa Hospital, Nizwa, Oman
| | - A Al-Madhani
- Department of Medicine, Sohar Hospital, Sohar, Oman
| | - M Al-Musalhi
- Laboratory Department, Ibra Hospital, Ibra, Oman
| | - S Y AlKindi
- Department of Internal Medicine, Al-Nahdha Hospital, Muscat, Oman
| | - G Al-Khadouri
- Department of Haematology, Sultan Qaboos University Hospital, Oman
| | - B Al Rawahi
- Department of Haematology, Sultan Qaboos University Hospital, Oman
| | - S Al-Ruqeishi
- Department of Haematology, Sultan Qaboos University Hospital, Oman
| | | | - Y A Wali
- Paediatric Haematology Unit, Child Health Department, College of Medicine, Sultan Qaboos University Oman
| | - S Al Shamakhi
- Nutrition Department, Ministry of Health, Muscat, Oman
| | - M Al Rawahi
- College of Medicine and Health Sciences, Muscat, Oman
| | - A V Pathare
- Department of Haematology, Sultan Qaboos University Hospital, Oman.
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25
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Walker SC, Murphy ML, Hendricks H, Dulek DE, Volanakis EJ, Borinstein SC. COVID-19 pneumonia in a pediatric sickle cell patient requiring red blood cell exchange. Clin Case Rep 2021; 9:1367-1370. [PMID: 33768846 PMCID: PMC7981740 DOI: 10.1002/ccr3.3774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/07/2022] Open
Abstract
Patients with sickle cell disease are already at high risk for respiratory complications, which SARS-CoV-2 can rapidly worsen. The case emphasizes the importance of efficiently maximizing standard therapies in sickle cell patients with COVID-19.
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Affiliation(s)
- Shannon C. Walker
- Division of Pediatric Hematology/OncologyVanderbilt University Medical CenterNashvilleTNUSA
| | - Meghan L. Murphy
- Division of Pediatric Hematology/OncologyVanderbilt University Medical CenterNashvilleTNUSA
| | - Hope Hendricks
- Division of Pediatric Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | - Daniel E. Dulek
- Division of Pediatric Infectious DiseasesVanderbilt University Medical CenterNashvilleTNUSA
| | - Emmanuel J. Volanakis
- Division of Pediatric Hematology/OncologyVanderbilt University Medical CenterNashvilleTNUSA
- Vanderbilt‐Meharry Center for Excellence in Sickle Cell DiseaseNashvilleTNUSA
| | - Scott C. Borinstein
- Division of Pediatric Hematology/OncologyVanderbilt University Medical CenterNashvilleTNUSA
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Stanoeva KR, van der Eijk AA, Meijer A, Kortbeek LM, Koopmans MPG, Reusken CBEM. Towards a sensitive and accurate interpretation of molecular testing for SARS-CoV-2: a rapid review of 264 studies. Euro Surveill 2021; 26:2001134. [PMID: 33706863 PMCID: PMC7953531 DOI: 10.2807/1560-7917.es.2021.26.10.2001134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/20/2020] [Indexed: 01/19/2023] Open
Abstract
BackgroundSensitive molecular diagnostics and correct test interpretation are crucial for accurate COVID-19 diagnosis and thereby essential for good clinical practice. Furthermore, they are a key factor in outbreak control where active case finding in combination with isolation and contact tracing are crucial.AimWith the objective to inform the public health and laboratory responses to the pandemic, we reviewed current published knowledge on the kinetics of SARS-CoV-2 infection as assessed by RNA molecular detection in a wide range of clinical samples.MethodsWe performed an extensive search on studies published between 1 December 2019 and 15 May 2020, reporting on molecular detection and/or isolation of SARS-CoV-2 in any human laboratory specimen.ResultsWe compiled a dataset of 264 studies including 32,515 COVID-19 cases, and additionally aggregated data points (n = 2,777) from sampling of 217 adults with known infection timeline. We summarised data on SARS-CoV-2 detection in the respiratory and gastrointestinal tract, blood, oral fluid, tears, cerebrospinal fluid, peritoneal fluid, semen, vaginal fluid; where provided, we also summarised specific observations on SARS-CoV-2 detection in pregnancy, infancy, children, adolescents and immunocompromised individuals.ConclusionOptimal SARS-CoV-2 molecular testing relies on choosing the most appropriate sample type, collected with adequate sampling technique, and with the infection timeline in mind. We outlined knowledge gaps and directions for future well-documented systematic studies.
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Affiliation(s)
- Kamelia R Stanoeva
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Adam Meijer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Laetitia M Kortbeek
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Chantal B E M Reusken
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
- Global Outbreak Alert and Response Network (GOARN), Geneva, Switzerland
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Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection. Blood Adv 2021; 5:207-215. [PMID: 33570644 PMCID: PMC7802524 DOI: 10.1182/bloodadvances.2020003456] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/25/2020] [Indexed: 12/19/2022] Open
Abstract
SCD patients with COVID-19 display a broad range of severity, with a higher case fatality than the non-SCD population (10.9% vs 3.3%). Older patients not treated with hydroxyurea with end organ damage who present with acute kidney injury, and elevated LDH and D-dimer level are at higher risk of death.
We aimed to identify predictors of outcomes and survival in patients living in 4 major metropolitan areas who had sickle cell disease (SCD) and COVID-19 to inform best approaches to prevention and care. Data were collected at baseline and during the clinical course in SCD patients diagnosed with COVID-19 in four COVID-19 epicenters. Patients were followed up posthospital discharge for up to 3 months. Of sixty-six SCD patients with COVID-19, fifty patients (75%) required hospitalization, and seven died (10.6%). Patients with preexisting kidney disease (chronic kidney disease) were more likely to be hospitalized. The most common presenting symptom was vaso-occlusive pain. Acute chest syndrome occurred in 30 (60%) of the 50 hospitalized patients and in all who died. Older age and histories of pulmonary hypertension, congestive heart failure, chronic kidney disease, and stroke were more prevalent in patients who died, as were higher creatinine, lactate dehydrogenase, and D-dimer levels. Anticoagulation use while inpatient was twice less common in patients who died. All deaths occurred in individuals not taking hydroxyurea or any other SCD-modifying therapy. Patients with SCD and COVID-19 exhibited a broad range of disease severity. We cannot definitively state that the overall mortality is higher in patients with SCD, although our case fatality rate was ∼10% compared with ∼3% in the general population, despite a median age of 34 years. Individuals with SCD aged >50 years, with preexisting cardiopulmonary, renal disease, and/or stroke not receiving hydroxyurea, who present with high serum creatinine, lactate dehydrogenase, and D-dimer levels, are at higher risk of death, irrespective of genotype or sex.
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Okar L, Rezek M, Gameil A, Mulikandayhil Y, Yassin MA. Severe hemolysis and vaso-occlusive crisis due to COVID-19 infection in a sickle cell disease patient improved after red blood cell exchange. Clin Case Rep 2021; 9:2117-2121. [PMID: 33821186 PMCID: PMC8013421 DOI: 10.1002/ccr3.3960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/23/2021] [Accepted: 02/08/2021] [Indexed: 01/07/2023] Open
Abstract
Even though most data suggest favorable outcome in patients with SCD and COVID‐19 infection, close monitoring remains essential as acute complication may develop unexpectedly. Offering RBC exchange early in the course of infection might improve prognosis.
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Affiliation(s)
- Lina Okar
- Department of medical education Hamad Medical Corporation Doha Qatar
| | - Mohamad Rezek
- Department of medical education Hamad Medical Corporation Doha Qatar
| | - Amna Gameil
- Department of medical education Hamad Medical Corporation Doha Qatar
| | | | - Mohamed A Yassin
- Department of medical oncology, hematology Section National Center for Cancer Care & Research Hamad Medical Corporation Doha Qatar
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29
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Hardy YO, Amenuke DAY, Abukari Y, Oti‐Acheampong A, Hutton‐Mensah K, Amoah‐Dankwah J, Amoabeng Kontoh S, Danso KA, Berchie PO, Otu‐Ansah C. Clinical presentations and outcomes of COVID-19 infection in sickle cell disease patients: Case series from Komfo Anokye teaching hospital, Ghana. Clin Case Rep 2021; 9:1018-1023. [PMID: 33598289 PMCID: PMC7869395 DOI: 10.1002/ccr3.3719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022] Open
Abstract
Patients with sickle cell disease and COVID-19 may not have a more dire outcome than the general population. Nevertheless, they may present with acute chest syndrome and other sickle cell crises which should be aggressively managed.
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Affiliation(s)
- Yasmine O. Hardy
- Department of MedicineKomfo Anokye Teaching Hospital/School of Medical SciencesKwame Nkrumah University of Science & TechnologyKumasiGhana
| | - Divine A. Y. Amenuke
- Department of MedicineKomfo Anokye Teaching Hospital/School of Medical SciencesKwame Nkrumah University of Science & TechnologyKumasiGhana
| | - Yakubu Abukari
- Department of MedicineKomfo Anokye Teaching HospitalKumasiGhana
| | - Alexander Oti‐Acheampong
- Department of DentistryKomfo Anokye Teaching Hospital/Kwame Nkrumah University of Science and TechnologyKomfo Anokye Teaching HospitalKumasiGhana
| | | | - James Amoah‐Dankwah
- Department of MedicineKomfo Anokye Teaching Hospital/School of Medical SciencesKwame Nkrumah University of Science & TechnologyKumasiGhana
| | - Samuel Amoabeng Kontoh
- Department of MedicineKomfo Anokye Teaching Hospital/College of Health SciencesKwame Nkrumah University of Science & TechnologyKumasiGhana
| | | | | | - Caleb Otu‐Ansah
- Department of PsychiatryKomfo Anokye Teaching HospitalKumasiGhana
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30
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Severe COVID-19 with acute respiratory distress syndrome (ARDS) in a sickle cell disease adult patient: case report. BMC Pulm Med 2021; 21:46. [PMID: 33514354 PMCID: PMC7844798 DOI: 10.1186/s12890-021-01412-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/14/2021] [Indexed: 01/30/2023] Open
Abstract
Background Sickle-cell anaemia is a widespread genetic disease prevalent worldwide among African and African-American populations. The pathogenesis is most often revealed by pulmonary conditions, including acute thoracic syndrome, which is affecting the life expectancy of these populations. The global spread of CoV2-SARS infection with a respiratory tropism, endothelial damages and procoagulant status endangers the SCD population. However, with only a few case reports, consequences of the Covid-19 pandemic on SCD population remain poorly known. Case presentation We report a case of a 33-year-old man with a history of homozygous SS homozygous sickle cell anemia who consulted on March 24, 2020 for febrile dyspnea 11 days after the onset of symptoms. A nasopharyngeal swab was positive for SARS-CoV-2. His respiratory status worsened rapidly in the emergency room and then in ICU leading to severe ARDS requiring intubation, curarization, and venovenous ECMO. Hematologically, severe hemolysis associated with major thrombocytopenia without documented spinal cord injury was noted. Several transfusion exchanges are performed. The evolution was finally slowly favorable and led to discharge from the intensive care unit and then from the hospital. Conclusions This case recalls the importance of an increased prevention policy against COVID-19among the SCD population. In addition, from a therapeutic point of view, it advocates (1) a high preventive anticoagulation from the outset according to the level of D-dimers (2) the use of venovenous ECMO in this particular case, whereas this technique has had rather disappointing results in acute chest syndromes. (3) Unexpectedly, our patient did not develop pulmonary arterial hypertension (PAH) and acute cor pulmonale (ACP), whereas this is a common feature of ARDS during SCD. These last two observations suggest a different pathophysiology of pulmonary disorders in SCD patients in the case of SARS COv2. It could be associated with marked hypoxemia secondary to pulmonary vascular vasodilation.
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Vilela TDS, Braga JAP, Loggetto SR. Hemoglobinopathy and pediatrics in the time of COVID-19. Hematol Transfus Cell Ther 2021; 43:87-100. [PMID: 33289008 PMCID: PMC7709722 DOI: 10.1016/j.htct.2020.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/17/2020] [Indexed: 12/13/2022] Open
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.
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32
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Okar L, Aldeeb M, Yassin MA. The role of red blood cell exchange in sickle cell disease in patient with COVID-19 infection and pulmonary infiltrates. Clin Case Rep 2021; 9:337-344. [PMID: 33362923 PMCID: PMC7753272 DOI: 10.1002/ccr3.3526] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 02/02/2023] Open
Abstract
Due to the overlap between ACS and COVID-19 pneumonia, we recommend close monitoring for those patients and offering them RBC exchange early in the course of the disease to avoid clinical deterioration.
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Affiliation(s)
- Lina Okar
- Department of Medical EducationHamad Medical CorporationDohaQatar
| | - Maya Aldeeb
- Department of Medical EducationHamad Medical CorporationDohaQatar
| | - Mohamed A. Yassin
- Department of Medical Oncology, Hematology SectionNational Center for Cancer Care & ResearchHamad Medical CorporationDohaQatar
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33
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Severance TS, Rahim MQ, French J, Baker RM, Shriner A, Khaitan A, Overholt KM. COVID-19 and hereditary spherocytosis: A recipe for hemolysis. Pediatr Blood Cancer 2021; 68:e28548. [PMID: 32710684 DOI: 10.1002/pbc.28548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/10/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Tyler S Severance
- Riley Hospital for Children, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Riley Hospital Division of Pediatric Hematology Oncology, Indianapolis, Indiana
| | - Mahvish Q Rahim
- Riley Hospital for Children, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Riley Hospital Division of Pediatric Hematology Oncology, Indianapolis, Indiana
| | - James French
- Riley Hospital for Children, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Riley Hospital Division of Pediatric Hematology Oncology, Indianapolis, Indiana
| | - Richelle M Baker
- Riley Hospital for Children, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Riley Hospital Division of Pediatric Hospital Medicine, Indianapolis, Indiana
| | - Andrew Shriner
- Riley Hospital for Children, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Riley Hospital Division of Pediatric Hospital Medicine, Indianapolis, Indiana
| | - Alka Khaitan
- Riley Hospital for Children, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Riley Hospital Division of Pediatric Infectious Disease, Indianapolis, Indiana
| | - Kathleen M Overholt
- Riley Hospital for Children, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Riley Hospital Division of Pediatric Hematology Oncology, Indianapolis, Indiana
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Acute Respiratory Distress Syndrome and COVID-19: A Scoping Review and Meta-analysis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1321:211-228. [PMID: 33656726 DOI: 10.1007/978-3-030-59261-5_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Acute respiratory distress syndrome (ARDS) is a fatal complication of the new severe acute respiratory syndrome coronavirus (SARS-CoV-2), which causes COVID-19 disease. This scoping review was carried out with international, peer-reviewed research studies and gray literature published up to July 2020 in Persian and English languages. Using keywords derived from MESH, databases including Magiran, IranMedex, SID, Web of Sciences, PubMed, Embase via Ovid, Science Direct, and Google Scholar were searched. After screening titles and abstracts, the full texts of selected articles were evaluated, and those which passed the criteria were analyzed and synthesized with inductive thematic analysis. Study quality was also evaluated using a standard tool. The overall prevalence of ARDS was estimated using a random-effects model. This led to identification of 23 primary studies involving 2880 COVID-19 patients. All articles were observational with a cross-sectional, retrospective, case report, and cohort design with moderate to strong quality. The main findings showed that COVID-19-related ARDS has a high prevalence and is different to ARDS due to other etiologies. Elderly and patients with comorbidities and organ failure should be closely surveyed for respiratory organ indications for several weeks after the onset of respiratory symptoms. There is currently no definitive treatment for ARDS in COVID-19 disease, and supportive therapies and their effects are somewhat controversial.
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35
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Elia GM, Angel A, Regacini R, Nais RP, Santos ARAD, Vieira PPMG, Braga JAP. Acute chest syndrome and COVID-19 in sickle cell disease pediatric patients. Hematol Transfus Cell Ther 2021; 43:104-108. [PMID: 33363267 PMCID: PMC7749646 DOI: 10.1016/j.htct.2020.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/30/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Gabriella Mafra Elia
- Departamento de Pediatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Andrea Angel
- Departamento de Pediatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rodrigo Regacini
- Departamento de Pediatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rafaela Pilotto Nais
- Departamento de Pediatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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36
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Zafari M, Rad MTS, Mohseni F, Nikbakht N. β-Thalassemia Major and Coronavirus-19, Mortality and Morbidity: a Systematic Review Study. Hemoglobin 2020; 45:1-4. [PMID: 33317358 DOI: 10.1080/03630269.2020.1857266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
β-Thalassemia (β-thal) is one of the most common inherited diseases all over the world. These patients are very susceptible to infection disease, and the mortality and morbidity of infected patients will increase. The object of this systematic review study was to determine mortality and morbidity of infected β-thal patients with coronavirus disease 2019 (COVID-19). We searched PubMed, Elsevier, and Scholar Google to obtain related papers. The time of search was 21 June until 17 July 2020. All original and review articles and case reports were searched with key words: COVID 19, beta or β-thalassemia (β-thal), mortality and morbidity. Data were extracted after quality assessment of all articles. We obtained seven, 21 and six articles from PubMed, Scholar Google and Science Direct, respectively. Finally, seven articles were discussed in our study. The total number of enrolled patients was 34. Twenty-six patients carried transfusion-dependent β-thal major (β-TM). The most common symptoms were fever, cough, pain and dyspnea. Nine patients died. The result of this study has shown that the mortality and morbidity of infected β-thal patients will escalate.
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Affiliation(s)
- Mandana Zafari
- Health Reproductive Research Center, Faculty of Medicine Sciences, Sari Branch, Islamic Azad University, Sari, Iran
| | - Mohammad T S Rad
- Psychiatry and Behavioral Science Center, Addiction Institute, Manzandaran University of Medical Science, Sari, Iran
| | - Fatemeh Mohseni
- Department of Nursing and Midwifery Science, Sari Branch, Islamic Azad University, Sari, Iran
| | - Nasimeh Nikbakht
- Department of Psychology Science, Sari Branch, Islamic Azad University, Sari, Iran
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37
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[Influence of COVID-19 on the occurrence and treatment of hemolytic diseases]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:878-880. [PMID: 33190454 PMCID: PMC7656072 DOI: 10.3760/cma.j.issn.0253-2727.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Affiliation(s)
- Laurel A Menapace
- Sickle Cell Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Swee Lay Thein
- Sickle Cell Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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39
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Dagalakis U, Hammershaimb E, McArthur MA, Macatangay RA. SARS-CoV-2 infection in pediatric patient with hemoglobin SC disease. Pediatr Blood Cancer 2020; 67:e28430. [PMID: 32776470 PMCID: PMC7435506 DOI: 10.1002/pbc.28430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/02/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Urania Dagalakis
- University of Maryland Children's Hospital, Department of PediatricsBaltimoreMaryland
| | - Elizabeth Hammershaimb
- University of Maryland Children's Hospital, Department of PediatricsBaltimoreMaryland,University of Maryland Division of Infectious Diseases and Tropical PediatricsBaltimoreMaryland
| | - Monica A. McArthur
- University of Maryland Children's Hospital, Department of PediatricsBaltimoreMaryland,University of Maryland Division of Infectious Diseases and Tropical PediatricsBaltimoreMaryland
| | - Regina A. Macatangay
- University of Maryland Children's Hospital, Department of PediatricsBaltimoreMaryland,University of Maryland Division of Pediatric Hematology/OncologyBaltimoreMaryland
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40
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Morrone KA, Strumph K, Liszewski MJ, Jackson J, Rinke ML, Silver EJ, Minniti C, Davila J, Mitchell WB, Manwani D. Acute chest syndrome in the setting of SARS-COV-2 infections-A case series at an urban medical center in the Bronx. Pediatr Blood Cancer 2020; 67:e28579. [PMID: 32893954 DOI: 10.1002/pbc.28579] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 12/21/2022]
Abstract
New York City has emerged as one of the epicenters of the SARS-COV-2 pandemic, with the Bronx being disproportionately affected. This novel coronavirus has caused significant respiratory manifestations raising the concern for development of acute chest syndrome (ACS) in patients with sickle cell disease (SCD). We report a series of pediatric SCD SARS-COV-2-positive patients admitted with ACS. SARS-COV-2-positive SCD patients, who did not develop ACS, were the comparison group. Hydroxyurea use (P-value = .02) and lower absolute monocyte counts (P-value = .04) were noted in patients who did not develop ACS. These preliminary findings need to be further evaluated in larger cohorts.
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Affiliation(s)
- Kerry A Morrone
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Albert Einstein College of Medicine, New York City, New York
| | - Kaitlin Strumph
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Albert Einstein College of Medicine, New York City, New York
| | - Mark J Liszewski
- Department of Radiology, Division of Pediatric Radiology, Albert Einstein College of Medicine, New York City, New York
| | - Jenai Jackson
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Albert Einstein College of Medicine, New York City, New York
| | - Michael L Rinke
- Department of Pediatrics, Division of Academic General Pediatrics, Albert Einstein College of Medicine, New York City, New York
| | - Ellen J Silver
- Department of Pediatrics, Division of Academic General Pediatrics and Montefiore School Health Program, Albert Einstein College of Medicine, New York City, New York
| | - Caterina Minniti
- Department of Medicine, Division of Hematology, Albert Einstein College of Medicine, New York City, New York
| | - Jennifer Davila
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Albert Einstein College of Medicine, New York City, New York
| | - William B Mitchell
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Albert Einstein College of Medicine, New York City, New York
| | - Deepa Manwani
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Albert Einstein College of Medicine, New York City, New York
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41
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Sivalingam T, Inusa B, Doyle P, Oteng-Ntim E. COVID-19 and the pulmonary complications of sickle cell disease. ACTA ACUST UNITED AC 2020; 1:545-547. [PMID: 33230510 PMCID: PMC7675298 DOI: 10.1002/jha2.105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 01/19/2023]
Abstract
Sickle cell disease (SCD) patients are commonly affected by pulmonary complications such as acute chest syndrome (ACS), pulmonary embolism (PE) and pneumonia that contribute to significant mortality risks. With a greater susceptibility to infection, they are deemed to be vulnerable patients during the current COVID‐19 pandemic. In emerging small case studies of SCD patients with COVID‐19 and further complicated by pneumonia, ACS, and/or PE, the clinical benefits of early exchange transfusion and Tocilizumab are evident. However, further clinical trials and larger cohort studies are essential to evaluate effective diagnostic and management options for this high‐risk group.
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Affiliation(s)
- Thivya Sivalingam
- Faculty of Life Sciences and Medicine GKT School of Medicine King's College London London UK
| | - Baba Inusa
- Department of Paediatrics Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust London UK
| | - Pat Doyle
- Department of Non-communicable Disease Epidemiology London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health London UK
| | - Eugene Oteng-Ntim
- Department of Obstetrics and Gynaecology Guy's and St Thomas' Hospital NHS Foundation Trust London UK
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42
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COVID-19 and sickle cell disease in Bahrain. Int J Infect Dis 2020; 101:14-16. [PMID: 32980556 PMCID: PMC7833176 DOI: 10.1016/j.ijid.2020.09.1433] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) is caused by a newly identified strain of the coronavirus family that has been shown to affect the hemoglobin beta chain, the same chain that has sickle cell disease (SCD) mutation. This study was undertaken to see if COVID-19 infection increased disease severity in patients with SCD. Methods Mass screening of the Bahraini population was undertaken between February and April 2020. Results A total of 38,092 Bahraini people were tested for COVID-19 during this period; 378 (1%) were SCD patients. Six patients with SCD had COVID-19 (1.6%): three remained asymptomatic, two had mild symptoms and one required oxygen therapy. The SCD patients had a similar average length of stay when compared with non-SCD COVID-19 patients (10.7 days). Conclusion The infection rate, clinical course and viral clearance seen for the SCD patients with COVID-19 were no different to those without SCD.
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Noun P, Ibrahim A, Hodroj MH, Bou-Fakhredin R, Taher AT. COVID-19 in benign hematology: emerging challenges and special considerations for healthcare professionals. Expert Rev Hematol 2020; 13:1081-1092. [DOI: 10.1080/17474086.2020.1819785] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Peter Noun
- Division of Pediatric Hematology-Oncology, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Ahmad Ibrahim
- Division of Hematology and Oncology, Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon
- Middle East Institute of Health, Lebanese University, Beirut, Lebanon
| | - Mohammad Hassan Hodroj
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rayan Bou-Fakhredin
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali T. Taher
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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44
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Nathan N, Prevost B, Sileo C, Richard N, Berdah L, Thouvenin G, Aubertin G, Lecarpentier T, Schnuriger A, Jegard J, Guellec I, Taytard J, Corvol H. The Wide Spectrum of COVID-19 Clinical Presentation in Children. J Clin Med 2020; 9:jcm9092950. [PMID: 32932612 PMCID: PMC7564665 DOI: 10.3390/jcm9092950] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Ten months after its appearance in December 2019, SARS-CoV-2 has infected more than 25 million patients worldwide. Because children were first identified as potential spreaders of the virus, schools were closed in several countries. However, it rapidly became evident that the number of hospitalized children infected by SARS-CoV-2 was dramatically lower than that of adults. To date, only hypotheses have been raised to explain this difference, so it is of great importance to describe the presentation of this disease among children. Here, we describe a wide spectrum of COVID-19 manifestation in children in a dedicated pediatric unit in France. Methods: Patients hospitalized with COVID-19 who were diagnosed on the basis of either positive SARS-CoV-2 RT-PCR in nasopharyngeal swabs and/or typical aspects in chest-computed tomography (CT) were included between March and May 2020 in Paris. Results: Twenty-three patients were included on the basis of positive RT-PCR (n = 20) and/or typical aspects in CT (n = 4). The median age was 4.9 years [0.1–17.6]. Patients were grouped by age (<2 years old: n = 14, 61%; 2–10 years old: n = 2, 9%; >10 years old: n = 7, 30%). Overweight or obesity was reported in only three patients. At presentation, the most frequent symptom in the overall cohort was fever (n = 18, 78%), followed by acute rhinitis (n = 9, 64%) and cough (n = 7, 50%) in the under 2-year-old group and cough (n = 4, 57%), fatigue, dyspnea and abdominal pain (n = 3, 43% each) in the over 10-year-old group. Five patients required ICU treatment, four of whom were aged >10 years, two presented with acute myocarditis, and two were sickle cell disease patients who presented with acute chest syndrome. Discussion and conclusion: The youngest patients seem to present milder forms of COVID-19 without the need for ICU treatment and with a shorter length of hospitalization. More severe evolutions were observed in teenagers, with, however, favorable outcomes. Given the context of closed schools and confinement, the infection of these children suggests intra-familial transmission that needs to be further assessed. This description might help to understand the intriguing differences in COVID-19 severity across age-classes.
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Affiliation(s)
- Nadia Nathan
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
- Sorbonne Université, Inserm UMR_S933, Childhood Genetic Disorders, 75012 Paris, France
| | - Blandine Prevost
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
| | - Chiara Sileo
- Pediatric Radiology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France;
| | - Nicolas Richard
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, 75012 Paris, France;
| | - Laura Berdah
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, 75012 Paris, France;
| | - Guillaume Thouvenin
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, 75012 Paris, France;
| | - Guillaume Aubertin
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, 75012 Paris, France;
| | - Thibault Lecarpentier
- Pediatric Emergency Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France;
| | - Aurélie Schnuriger
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, 75012 Paris, France;
- Virology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France
| | - Julien Jegard
- Pediatric and Neonatal Intensive Care Unit, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (J.J.); (I.G.)
| | - Isabelle Guellec
- Pediatric and Neonatal Intensive Care Unit, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (J.J.); (I.G.)
| | - Jessica Taytard
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
- Sorbonne Université, Inserm UMR_S1158, Experimental and clinical respiratory neurophysiology, 75013 Paris, France
| | - Harriet Corvol
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, 75012 Paris, France; (N.N.); (B.P.); (N.R.); (L.B.); (G.T.); (G.A.); (J.T.)
- Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Inserm UMR_S938, 75012 Paris, France;
- Correspondence:
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45
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Kaur S, Bansal R, Kollimuttathuillam S, Gowda AM, Singh B, Mehta D, Maroules M. The looming storm: Blood and cytokines in COVID-19. Blood Rev 2020; 46:100743. [PMID: 32829962 PMCID: PMC7431319 DOI: 10.1016/j.blre.2020.100743] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/29/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023]
Abstract
A novel coronavirus termed as COVID-19 by WHO has been the causative agent of an unprecedented pandemic in the history of humanity. The global burden of mortality and morbidity associated with this pandemic continues to increase with each passing day as it is progressively leading to multiorgan dysfunction. In most cases, the cause of death has been attributed to respiratory failure, sepsis, cardiac failure, kidney injury, or coagulopathy. As more knowledge is being unfolded, an in-depth understanding of various systemic manifestations and complications of SARS-CoV2 is vital for optimum management of these patients. This novel virus is known to spread faster than its two ancestors, the SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), demonstrating a case fatality ranging from 5 to 8% [1]. Hematological abnormalities such as lymphopenia, thrombocytopenia, elevated D-Dimer, elevated fibrinogen, elevated fibrinogen degradation products as well as cytokines such as IL-6 are emerging as important prognostic marker for worse outcome of COVID-19. Among various systemic manifestations, hematological complications such as venous thrombosis causing pulmonary embolism or deep vein thrombosis, and arterial thrombosis causing myocardial infarction, strokes or limb ischemia are being noted to be directly linked to high mortality from COVID-19. An attempt to understand the pathophysiology of various hematological abnormalities including cytokine storm, hypercoagulable state and some rare presentations of this disease hence becomes imperative. Through this review, we aim to provide an up-to-date summary of current evidence-based literature of hematological manifestations, their consequences and management including role of anticoagulation and drugs targeting cytokine storm in patients with SARS-CoV-2.
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Affiliation(s)
- Supreet Kaur
- Department of Hematology and Oncology, St. Joseph University Medical Center, 703 Main Street, Paterson, NJ 07503, USA.
| | - Rashika Bansal
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) National Institutes of Health, 6555 Rock Spring Dr, Bethesda, MD 20817, USA
| | - Sudarsan Kollimuttathuillam
- Department of Hematology and Oncology, St. Joseph University Medical Center, 703 Main Street, Paterson, NJ 07503, USA
| | - Anusha Manje Gowda
- Department of Hematology and Oncology, St. Joseph University Medical Center, 703 Main Street, Paterson, NJ 07503, USA
| | - Balraj Singh
- Department of Hematology and Oncology, St. Joseph University Medical Center, 703 Main Street, Paterson, NJ 07503, USA
| | - Dhruv Mehta
- Division of Gastroenterology and Hepatobiliary disease, Westchester Medical Center at New York Medical College, 100 Woods Road, Valhalla, NY 10595, USA
| | - Michael Maroules
- Department of Hematology and Oncology, St. Joseph University Medical Center, 703 Main Street, Paterson, NJ 07503, USA.
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46
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Odièvre M, Marcellus C, Ducou Le Pointe H, Allali S, Romain A, Youn J, Taytard J, Nathan N, Corvol H. Dramatic improvement after tocilizumab of severe COVID-19 in a child with sickle cell disease and acute chest syndrome. Am J Hematol 2020; 95:E192-E194. [PMID: 32358817 PMCID: PMC7267654 DOI: 10.1002/ajh.25855] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Marie‐Hélène Odièvre
- Department of General PediatricsCenter for Sickle Cell Disease, Trousseau Hospital, Assistance Publique ‐ Hôpitaux de Paris (AP‐HP), Sorbonne Université Paris France
| | - Charles Marcellus
- Pediatric Intensive Care UnitNecker‐Enfants‐Malades Hospital, AP‐HP, Université de Paris Paris France
| | | | - Slimane Allali
- Department of General Pediatrics and Pediatric Infectious DiseasesReference Center for Sickle Cell Disease, Necker‐Enfants‐Malades Hospital, AP‐HP, Université de Paris Paris France
| | - Anne‐Sophie Romain
- Department of General PediatricsCenter for Sickle Cell Disease, Trousseau Hospital, Assistance Publique ‐ Hôpitaux de Paris (AP‐HP), Sorbonne Université Paris France
| | - Jenny Youn
- Department of General PediatricsCenter for Sickle Cell Disease, Trousseau Hospital, Assistance Publique ‐ Hôpitaux de Paris (AP‐HP), Sorbonne Université Paris France
| | - Jessica Taytard
- Pediatric Pulmonology DepartmentTrousseau Hospital, AP‐HP, Sorbonne Université Paris France
| | - Nadia Nathan
- Pediatric Pulmonology DepartmentTrousseau Hospital, AP‐HP, Sorbonne Université Paris France
| | - Harriet Corvol
- Pediatric Pulmonology DepartmentTrousseau Hospital, AP‐HP, Sorbonne Université Paris France
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47
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Taher AT, Bou‐Fakhredin R, Kreidieh F, Motta I, De Franceschi L, Cappellini MD. Care of patients with hemoglobin disorders during the COVID-19 pandemic: An overview of recommendations. Am J Hematol 2020; 95:E208-E210. [PMID: 32394480 PMCID: PMC7272998 DOI: 10.1002/ajh.25857] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Ali T. Taher
- Division of Hematology and Oncology, Department of Internal MedicineAmerican University of Beirut Medical Center Beirut Lebanon
| | - Rayan Bou‐Fakhredin
- Division of Hematology and Oncology, Department of Internal MedicineAmerican University of Beirut Medical Center Beirut Lebanon
| | - Firas Kreidieh
- Division of Hematology and Oncology, Department of Internal MedicineAmerican University of Beirut Medical Center Beirut Lebanon
| | - Irene Motta
- Department of Clinical Sciences and Community HealthUniversity of Milan Milan Italy
- Fondazione IRCCS Caʼ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Lucia De Franceschi
- Department of MedicineUniversity of Verona and Azienda ospedaliera Universitaria Intergrata Verona Italy
| | - Maria Domenica Cappellini
- Department of Clinical Sciences and Community HealthUniversity of Milan Milan Italy
- Fondazione IRCCS Caʼ Granda Ospedale Maggiore Policlinico Milan Italy
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48
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Appiah-Kubi A, Acharya S, Fein Levy C, Vlachos A, Ostovar G, Murphy K, Farrell A, Brower D, Lipton JM, Wolfe L, Aygun B. Varying presentations and favourable outcomes of COVID-19 infection in children and young adults with sickle cell disease: an additional case series with comparisons to published cases. Br J Haematol 2020; 190:e221-e224. [PMID: 32652551 PMCID: PMC7405127 DOI: 10.1111/bjh.17013] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/19/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Abena Appiah-Kubi
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Suchitra Acharya
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Carolyn Fein Levy
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Adrianna Vlachos
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Gholamabbas Ostovar
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.,Division Infectious Diseases, Cohen Children's Medical Center, Northwell Health, NY, USA
| | - Kristina Murphy
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.,Division Pediatric Intensive Care, Cohen Children's Medical Center, Northwell Health, NY, USA
| | - Antonella Farrell
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Donna Brower
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Jeffrey M Lipton
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Lawrence Wolfe
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Banu Aygun
- Division of Hematology/Oncology and Cellular Therapy, Cohen Children's Medical Center, Northwell Health, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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49
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Tonen-Wolyec S, Marini Djang'eing'a R, Kambale-Kombi P, Tshilumba CK, Bélec L, Batina-Agasa S. Vulnerability of sickle cell disease persons to the COVID-19 in sub-Saharan Africa. ACTA ACUST UNITED AC 2020; 25:280-282. [PMID: 32657260 DOI: 10.1080/16078454.2020.1790842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Serge Tonen-Wolyec
- Ecole Doctorale Régionale D'Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon.,Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Roland Marini Djang'eing'a
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.,Faculty of Medicine, University of Liège, Liège, Belgium
| | - Paul Kambale-Kombi
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Charles Kayembe Tshilumba
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Laurent Bélec
- Faculty of Medicine, University of Paris Descartes, Paris, France
| | - Salomon Batina-Agasa
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
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50
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Kehinde TA, Osundiji MA. Sickle cell trait and the potential risk of severe coronavirus disease 2019-A mini-review. Eur J Haematol 2020; 105:519-523. [PMID: 32589774 PMCID: PMC7361772 DOI: 10.1111/ejh.13478] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/14/2022]
Abstract
Coronavirus Disease 2019 (COVID‐19) pandemic is a rapidly evolving public health problem. The severity of COVID‐19 cases reported hitherto has varied greatly from asymptomatic to severe pneumonia and thromboembolism with subsequent mortality. An improved understanding of risk factors for adverse clinical outcomes may shed some light on novel personalized approaches to optimize clinical care in vulnerable populations. Emerging trends in the United States suggest possibly higher mortality rates of COVID‐19 among African Americans, although detailed epidemiological study data is pending. Sickle cell disease (SCD) disproportionately affects Black/African Americans in the United States as well as forebearers from sub‐Saharan Africa, the Western Hemisphere (South America, the Caribbean, and Central America), and some Mediterranean countries. The carrier frequency for SCD is high among African Americans. This article underscores the putative risks that may be associated with COVID‐19 pneumonia in sickle cell trait as well as potential opportunities for individualized medical care in the burgeoning era of personalized medicine.
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Affiliation(s)
| | - Mayowa Azeez Osundiji
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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