ABSTRACT
Vaccines against acute respiratory syndrome Coronavirus 2(SARS-CoV2) are critical weapons to control the spread of the deadly Coronavirus 2019(COVId-19) virus worldwide. Although these vaccines are generally safe, their widespread use has produced reports of rare complications, including vaccine-induced immune thrombotic thrombocytopenia (VIITT), particularly in connection with ChAdOx1 nCov-19. We have identified three cases of sickle cell disease (SCD) experiencing a severe vaso-occlusive crisis (VOC) shortly after the vaccine. Despite being stable for a long time, they had fever with tachycardia, along with a significant rise in WBC, liver enzymes, particularly alkaline phosphate, with a remarkable drop in hemoglobin, and platelets and one of them had probably a fatal TTP like syndrome. Given these findings, physicians and patients should exercise caution when taking this type of vaccine and be aware of these safety concerns.
ABSTRACT
OBJECTIVES: The study aimed to assess COVID-19 impact on the morbidity and mortality of vasooclusive crisis (VOC) in sickle cell anaemia (SCA) patients. METHODS: A prospective cohort study of 100 SCA patients; 50 with COVID-19 (COVID group) and 50 without (non-COVID group). All patients signed written informed consent. RESULTS: The COVID group had a significantly higher VOC episode median per year; 3 (IQR,1-6) vs 2 (IQR,2-12) (P < 0.05). The need for hospitalisation was similar in both groups. The non-COVID group had more history of culture-proven infection (P = 0.05). The COVID-group had more osteonecrosis (P < 0.05), splenic sequestration, splenomegaly and hepatic crisis (P = 0.05, 0.006, 0.02; respectively) and significantly higher (P < 0.05) symptoms of fever, cough, fatigue, abdominal pain and anosmia. Mean haemoglobin, lymphocyte subset, platelets, and reticulocytes were reduced in both groups, while lactate dehydrogenase and ferritin levels were significantly elevated. In the COVID group, the rise in white blood cell count, reticulocyte percentage, platelets and ferritin was subdued (P < 0.05). Two patients in the COVID group and 3 in the non-COVID group died; there was no statistically significant difference in mortality. CONCLUSIONS: Although COVID-19 may have triggered the onset of VOC, it did not significantly influence VOC-related morbidity or mortality in this SCA cohort.
Subject(s)
Acute Chest Syndrome/blood , Acute Chest Syndrome/epidemiology , Anemia, Sickle Cell/blood , Anemia, Sickle Cell/epidemiology , COVID-19/blood , COVID-19/epidemiology , SARS-CoV-2 , Acute Chest Syndrome/mortality , Adult , Anemia, Sickle Cell/mortality , COVID-19/mortality , Cohort Studies , Comorbidity , Female , Ferritins/blood , Hospitalization , Humans , L-Lactate Dehydrogenase/blood , Leukocyte Count , Lymphocyte Count , Male , Platelet Count , Prospective Studies , ReticulocytesABSTRACT
Introduction In 2012, MERS-CoV was identified in Saudi Arabia and resulted in more than 2442 confirmed cases worldwide by May 2019. MERS-CoV infection in children is less common. A review of MERS-CoV in children from 2012 to April 2016 summarized the clinical manifestation of 31 reported cases. Most children were asymptomatic or had mild respiratory symptoms, and severe infection reported in patients with comorbid conditions. We aimed to study the clinical characteristics of pediatric MERS CoV infected cases in UAE supported by literature review.