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

S Alkindi1, R A Elsadek2, A Al-Madhani3

  • 1Department of Haematology, Sultan Qaboos University Hospital, Oman; College of Medicine and Health Sciences, Muscat, Oman.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|March 20, 2021
PubMed

Insights

COVID-19 may trigger vasooclusive crisis (VOC) in sickle cell anaemia (SCA) patients, but did not significantly increase VOC-related morbidity or mortality in this cohort.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Public Health

Background:

  • Sickle cell anaemia (SCA) is a genetic blood disorder characterized by abnormal haemoglobin, leading to vasooclusive crises (VOCs).
  • The impact of COVID-19 on SCA patients, particularly concerning VOCs, requires thorough investigation due to potential synergistic effects on morbidity and mortality.

Purpose of the Study:

  • To evaluate the effect of COVID-19 infection on the frequency and severity of vasooclusive crises (VOCs) in patients with sickle cell anaemia (SCA).
  • To assess the influence of COVID-19 on the morbidity and mortality associated with VOCs in SCA patients.

Main Methods:

  • A prospective cohort study involving 100 SCA patients, divided into two groups: 50 with confirmed COVID-19 (COVID group) and 50 without (non-COVID group).
  • Data collection included VOC episodes, hospitalizations, specific clinical manifestations, laboratory markers (hemoglobin, white blood cell count, platelets, lactate dehydrogenase, ferritin), and mortality rates.

Main Results:

  • The COVID group experienced a higher median number of VOC episodes annually (3 vs 2, P < 0.05) and presented with more specific complications like osteonecrosis, splenic sequestration, splenomegaly, and hepatic crisis.
  • While both groups showed reduced mean hemoglobin and lymphocyte subsets, the COVID group exhibited a subdued rise in white blood cell count, reticulocyte percentage, platelets, and ferritin.
  • Hospitalization rates were similar between groups, and there was no statistically significant difference in mortality (2 deaths in the COVID group vs 3 in the non-COVID group).

Conclusions:

  • COVID-19 infection may act as a trigger for vasooclusive crises (VOCs) in individuals with sickle cell anaemia (SCA).
  • Despite increased VOC episodes and certain complications, COVID-19 did not significantly elevate overall VOC-related morbidity or mortality within this SCA cohort.
Abstract

Keywords:
COVID-19CoronavirusSCASickle cell anaemiaVasooclusive crises

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