We all know that COVID-19 affects people differently depending on their preexisting health condition. Now researchers are saying that those with sickle cell disease may be at an even higher risk of not only contracting the virus but serious complications and even death.
This comes from the results of two studies presented at the ASH Annual Meeting and Exposition last month.
Lana Mucalo, MD, postdoctoral fellow at Medical College of Wisconsin, and her team wrote in their study’s findings that sickle cell patients faced 6.2 times the risk for COVID-19-related mortality compared with the general Black population.
Mucalo said there are several different factors that came into play here.
“Patients with sickle cell disease are more likely to have a high prevalence of the various comorbidities that can put individuals at high risk [for] severe illness and death,” she said. “Also, previous studies show that [patients with sickle cell disease] have worse outcomes due to influenza infection compared with the general population, so respiratory viral infections, potentially COVID-19 too, are a significant source of morbidity and mortality for them.”
Ashima Singh, MS, Ph.D., research scientist in the department of pediatrics at Medical College of Wisconsin, and colleagues concluded that patients with sickle cell disease and COVID-19 are more likely to be hospitalized with pneumonia and pain than Black individuals with COVID-19 but without sickle cell disease.
Of course, patients with preexisting conditions are known to have more dyer outcomes from COVID-19 diagnoses, but these studies made the link between that and sickle cell patients.
Also, the researchers pointed out that COVID-19 has been shown to disproportionately
impact Black people, with a 22.2% death rate among them compared with a 13% death rate for the general population.
“There is really very limited knowledge of COVID-19 outcomes among individuals with sickle cell trait,” Singh said in an interview with Healio.com.
During their research, Mucalo and her team collected information from the international SECURE-SCD Registry — a voluntary reporting system developed at Medical College of Wisconsin to collect data on children and adults with COVID-19 and sickle cell disease — to analyze COVID-19 hospitalization rates compared with Black patients with the virus.
Researchers also took a close look at factors linked with more severe COVID-19 illness and hospitalization among those with sickle cell disease.
Their report showed 152 children (mean age, 10.9 years; 46.7% female) and 214 adults (mean age, 34 years; 58.1% women) with sickle cell disease and COVID-19, most of whom (n = 324) were from the U.S. Of them, the findings stated that hospitalization rates of 46.1% among children and 66.8% among adults, and death rates of 0.7% among children and 7% among adults.
Overall, these data showed patients with sickle cell disease were 6.2 times more likely to die of COVID-19 infection, according to Mucalo.
These data may be limited by selection bias, with an overrepresentation of patients with more severe illness and underrepresentation of areas with a lack of testing, according to Mucalo. Also, the case fatality rate for the general population was derived from only one state.
Overall, the researchers found that sickle cell patients should be following recommended precautions such as mask-wearing, hand hygiene, and social distancing because it does significantly decrease the likelihood of contracting the virus.
But, sickle cell patients should be sure to get tested frequently and keep a close eye on symptoms of COVID-19 and associated with sickle cell flare-ups.
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