Presentations and outcomes among sickle cell disease patients with COVID-19 at a large southern healthcare system

ABSTRACT

Objectives

Compared with the general population, patients with sickle cell disease (SCD) typically have substantially reduced life expectancies. It is unclear whether SCD patients who acquire COVID-19 have higher rates of complications and mortality than the general population. We sought to elucidate COVID-19 presentation and outcomes in patients with SCD.

Methods

Using retrospective chart review, we evaluated demographic characteristics, presenting symptoms, chest imaging findings, blood transfusion requirements, need for mechanical ventilation or pressor support, medication administration (including remdesivir and dexamethasone), and survival among individuals with SCD hospitalized with COVID-19 from March 2020 to December 2021.

Results

Among 72 SCD patients, increased pain was the most common presenting symptom followed by cough, fever, and dyspnea. Thirty-seven (44%) received simple transfusion and 14 (17%) underwent exchange transfusion. Lung imaging findings suggestive of COVID-19 were observed in 27 (37%) patients; 21 (29%) patients were treated with remdesivir and 26 (35%) received dexamethasone. Three patients (4%) required mechanical ventilation and pressor support; all three died from COVID complications.

Conclusions

Pain is the most common presenting symptom in SCD patients with COVID-19. We observed a mortality rate higher than that among the general population among patients who required mechanical ventilation and pressor support.

KEYWORDS:

• COVID-19
• clinical outcomes
• presenting symptoms
• sickle cell disease

Declaration of interest

The authors have no relevant affiliations of financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

KA Clarke, M McLemore, and F El Rassi developed the study concept and participated in the writing, review, and revision of the manuscript. KA Clarke, M Moussa, and YM Shin did the initial data analysis, and performed the chart review. All 3 participated in the writing, review and revision of the manuscript. MAK Hall participated in the writing, review, and revision of the manuscript.

All authors reviewed data and contributed to developing and editing the final manuscript. All authors gave final approval of this version to be published and agree to be accountable for all aspects of this work.

Additional information

Funding

This paper was not funded.