While COVID-19 does not appear to carry an increased risk of morbidity or mortality for patients with sickle cell disease (SCD), vaso-occlusive crisis can complicate COVID-19 in approximately half of hospitalised patients, states a study published in Lancet Haematology.
The prevalence of admission to an intensive care unit (ICU) in France due to COVID-19 were compared between patients with SCD and COVID-19 inpatients during the same period.
Of 83 hospitalised patients with SCD, 48 (58%) had a past medical history of acute chest syndrome. Vaso-occlusive crisis was associated with COVID-19 in 44 (54%) of 81 inpatients and acute chest syndrome in 23 (28%) of 82 patients. Older patients with sickle cell disease should be considered vulnerable to SARS-CoV-2, the authors advise.
Nine of the 17 patients admitted to ICU required mechanical ventilation, and two patients died. Five (63%) of eight patients with the SC genotype were admitted to ICU, compared with 12 (17 %) of 71 patients with the SS/Sβ⁰ genotype. The hypothesis of a protective effect against COVID-19 in patients with the SS/Sβ⁰ variant should be explored.
Data do not support an effect of transfusions or hydroxyurea for preventing ICU admission for the management of COVID-19 in patients with SCD.