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

• DOI: 10.1016/j.ijid.2021.03.044
• Publication Date: 2021-03-18T17:20:08Z
• Authors: S. Alkindi; R.A. Elsadek; A. Al-Madhani; M. Al-Musalhi; S.Y. AlKindi; G. Al-Khadouri; B. Al Rawahi; S. Al-Ruqeishi; J. Al-Yazeedi; Y.A. Wali; S. Al Shamakhi; M. Al Rawahi; A.V. Pathare
• Keywords: Adult; Male; Reticulocytes; Infectious and parasitic diseases; RC109-216; Anemia, Sickle Cell; Comorbidity; Article; Cohort Studies; Leukocyte Count; 03 medical and health sciences; 0302 clinical medicine; Acute Chest Syndrome; Humans; Lymphocyte Count; Prospective Studies; L-Lactate Dehydrogenase; Platelet Count; SARS-CoV-2; Sickle cell anaemia; Vasooclusive crises; COVID-19; SCA; 3. Good health; Coronavirus; Hospitalization; Ferritins; Female

The study aimed to assess COVID-19 impact on the morbidity and mortality of vasooclusive crisis (VOC) in sickle cell anaemia (SCA) patients.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.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.Although COVID-19 may have triggered the onset of VOC, it did not significantly influence VOC-related morbidity or mortality in this SCA cohort.