Case Report: Obstetric and COVID-19-Related Morbidity and Mortality in Three Patients with Sickle Hemoglobinopathy

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Infectious Diseases

Background:

• Sickle cell disease (SCD) affects approximately 3% of pregnant women globally.
• The COVID-19 pandemic (caused by SARS-CoV-2) poses significant risks, particularly for immunocompromised individuals.
• Limited research exists on the impact of COVID-19 on pregnant women of Afro-Caribbean descent with SCD.

Observation:

• A retrospective case series analyzed three pregnant patients with SCD who contracted COVID-19 at the University Hospital of the West Indies between 2020 and 2022.
• Complications included vaso-occlusive crisis, need for ventilatory support, and severe adverse outcomes.
• Two patients had hemoglobin SC disease, and one had hemoglobin SS disease.

Findings:

• The study documented severe maternal and neonatal complications, including the demise of both a mother and her newborn.
• Vaso-occlusive crisis was a frequent presentation among these patients.
• Two out of three patients required mechanical ventilation due to respiratory compromise.

Implications:

• Pregnant women with SCD are at high risk for adverse outcomes when infected with SARS-CoV-2.
• Maternal and neonatal mortality are possible sequelae, even with supportive care.
• Further research is crucial to understand and mitigate these risks in vulnerable populations.