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Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection.
Minniti, Caterina P; Zaidi, Ahmar U; Nouraie, Mehdi; Manwani, Deepa; Crouch, Gary D; Crouch, Andrew S; Callaghan, Michael U; Carpenter, Sarah; Jacobs, Charleen; Han, Jin; Simon, Jena; Glassberg, Jeffrey; Gordeuk, Victor R; Klings, Elizabeth S.
  • Minniti CP; Division of Hematology, Montefiore Health Systems, Albert Einstein College of Medicine, Bronx, NY.
  • Zaidi AU; Division of Hematology/Oncology, Children's Hospital of Michigan/Central Michigan University, Detroit, MI.
  • Nouraie M; Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.
  • Manwani D; Division of Pediatric Hematology, Montefiore Health Systems, Albert Einstein College of Medicine, Bronx, NY.
  • Crouch GD; Division of Pediatric Hematology/Oncology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Crouch AS; Division of Hematology, Montefiore Health Systems, Albert Einstein College of Medicine, Bronx, NY.
  • Callaghan MU; Division of Hematology/Oncology, Children's Hospital of Michigan/Central Michigan University, Detroit, MI.
  • Carpenter S; Department of Emergency Medicine, Boston University School of Medicine, Boston, MA.
  • Jacobs C; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Han J; Center for Pharmacoepidemiology and Pharmacoeconomic Research, College of Pharmacy, and.
  • Simon J; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Glassberg J; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Gordeuk VR; Division of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL; and.
  • Klings ES; The Pulmonary Center, Boston University School of Medicine, Boston, MA.
Blood Adv ; 5(1): 207-215, 2021 01 12.
Article in English | MEDLINE | ID: covidwho-1035171
ABSTRACT
We aimed to identify predictors of outcomes and survival in patients living in 4 major metropolitan areas who had sickle cell disease (SCD) and COVID-19 to inform best approaches to prevention and care. Data were collected at baseline and during the clinical course in SCD patients diagnosed with COVID-19 in four COVID-19 epicenters. Patients were followed up posthospital discharge for up to 3 months. Of sixty-six SCD patients with COVID-19, fifty patients (75%) required hospitalization, and seven died (10.6%). Patients with preexisting kidney disease (chronic kidney disease) were more likely to be hospitalized. The most common presenting symptom was vaso-occlusive pain. Acute chest syndrome occurred in 30 (60%) of the 50 hospitalized patients and in all who died. Older age and histories of pulmonary hypertension, congestive heart failure, chronic kidney disease, and stroke were more prevalent in patients who died, as were higher creatinine, lactate dehydrogenase, and D-dimer levels. Anticoagulation use while inpatient was twice less common in patients who died. All deaths occurred in individuals not taking hydroxyurea or any other SCD-modifying therapy. Patients with SCD and COVID-19 exhibited a broad range of disease severity. We cannot definitively state that the overall mortality is higher in patients with SCD, although our case fatality rate was ∼10% compared with ∼3% in the general population, despite a median age of 34 years. Individuals with SCD aged >50 years, with preexisting cardiopulmonary, renal disease, and/or stroke not receiving hydroxyurea, who present with high serum creatinine, lactate dehydrogenase, and D-dimer levels, are at higher risk of death, irrespective of genotype or sex.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Anemia, Sickle Cell Type of study: Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Young adult Language: English Journal: Blood Adv Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Anemia, Sickle Cell Type of study: Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Young adult Language: English Journal: Blood Adv Year: 2021 Document Type: Article