Impact of COVID-19 Infection on 24 Patients with Sickle Cell Disease. One Center Urban Experience, Detroit, MI, USA

Abstract

The city of Detroit has a large population of individuals with sickle cell disease, and hospitals in Detroit have seen some of the highest numbers of cases of coronavirus disease-19 (COVID-19) in 2020. The purpose of this study was to examine the pathophysiological characteristics of COVID-19 in patients with sickle cell disease or trait to determine whether these patients have unique manifestations that might require special consideration. This retrospective analysis included 24 patients with confirmed COVID-19 and sickle cell disease or trait who were seen at the Henry Ford Hospital, Detroit, MI, USA, between March 1 and April 15 2020. Of the 24 patients, 18 (75.0%) had heterozygous sickle cell trait, one (4.0%) was a double heterozygote for Hb S (HBB: c.20A>T)/β⁺-thalassemia (β⁺-thal), four had sickle cell anemia (β^S/β^S) and one (4.0%) had Hb S/Hb C (HBB: c.19G>A) disease. A total of 13 (54.0%) patients required hospitalization. All four patients with sickle cell anemia, developed acute pain crisis. We observed one patient who developed acute pulmonary embolism and no patients developed other sickle cell associated complications. Additionally, three (13.0%) patients required packed red blood cell transfusion without the need of exchange transfusion, and one patient required admission to the intensive care unit (ICU), mechanical ventilation and subsequently died. Patients with sickle cell disease or trait and laboratory-confirmed COVID-19 had a generally mild, or unremarkable, course of disease, with lower chances of intubation, ICU admission and death, but with a slightly longer hospitalization.

Keywords:

• Coronavirus disease-19 (COVID-19)
• sickle cell disease
• sickle cell trait
• severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
• acute respiratory distress syndrome (ARDS)

Acknowledgments

The authors thank Karla D. Passalacqua, Ph.D., at the Henry Ford Hospital, who is funded through Graduate Medical Education, for assistance with writing and editing. All authors made a substantial intellectual contribution to the study, interpreted the data, discussed the results, contributed to the final manuscript, and agree with the final submission. N. Balanchivadze designed and directed the project, developed the main conceptual ideas and manuscript outline, extracted data, performed the data analysis, and wrote the first draft of the manuscript. A.A. Kudirka, S. Askar, K. Almadhoun and R. Fadel performed data extraction, designed tables, and critically reviewed the manuscript. P. Kuriakose provided critical edits to the manuscript. V. Dabak supervised the work, design and planning, and provided critical edits to the final manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.