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Thalassaemia is paradoxically associated with a reduced risk of in-hospital complications and mortality in COVID-19: Data from an international registry.
El-Battrawy, Ibrahim; Longo, Filomena; Núñez Gil, Iván J; Abumayyaleh, Mohammad; Gianesin, Barbara; Estrada, Vicente; Aparisi, Álvaro; Arroyo-Espliguero, Ramón; Balocco, Manuela; Barella, Susanna; Beccaria, Andrea; Bonetti, Federico; Casale, Maddalena; De Michele, Elisa; Denotti, Anna Rita; Fidone, Carmelo; Fortini, Monica; Gamberini, Maria Rita; Graziadei, Giovanna; Lisi, Roberto; Massa, Antonella; Marcon, Alessia; Rubinski, Bryan; Miano, Maurizio; Motta, Irene; Pinto, Valeria Maria; Piperno, Alberto; Mariani, Raffaella; Putti, Maria Caterina; Quota, Alessandra; Ribersani, Michela; Marziali, Marco; Roberti, Domenico; Rosso, Rosamaria; Tartaglione, Immacolata; Vitucci, Angelantonio; Voi, Vincenzo; Zecca, Marco; Romero, Rodolfo; Marouneld, Charbel; Fernández-Rozas, Inmaculada; Espejo, Carolina; Marhaeni, Wulandewi; Garcia Aguado, Marcos; Cappellini, Maria Domenica; Perrotta, Silverio; De Franceschi, Lucia; Piga, Antonio; Forni, Gian Luca; Akin, Ibrahim.
  • El-Battrawy I; University of Mannheim, Mannheim, Germany.
  • Longo F; Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
  • Núñez Gil IJ; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
  • Abumayyaleh M; ForAnemia Foundation, Genoa, Italy.
  • Gianesin B; University of Mannheim, Mannheim, Germany.
  • Estrada V; Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Aparisi Á; Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
  • Arroyo-Espliguero R; Hospital Universitario Guadalajara, Guadalajara, Spain.
  • Balocco M; E.O. Ospedali Galliera, Genoa, Italy.
  • Barella S; SSD Talassemia. Ospedale Pediatrico Microcitemico A. Cao, Cagliari, Italy.
  • Beccaria A; Istituto Giannina Gaslini, Genoa, Italy.
  • Bonetti F; Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Casale M; Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
  • De Michele E; AOU OO.RR. San Giovanni di Dio Ruggi d'Aragona, Salerno, Italy.
  • Denotti AR; Unità operativa semplice Studio Emoglobinopatie Simt, Ragusa, Italy.
  • Fidone C; SSD Talassemia. Ospedale Pediatrico Microcitemico A. Cao, Cagliari, Italy.
  • Fortini M; Azienda Ospedaliero-Universitaria S.Anna di Ferrara, Ferrara, Italy.
  • Gamberini MR; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
  • Graziadei G; Azienda Ospedaliero-Universitaria S.Anna di Ferrara, Ferrara, Italy.
  • Lisi R; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Massa A; Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Italy.
  • Marcon A; Ospedale Giovanni Paolo II, Olbia, Italy.
  • Rubinski B; ASST-Monza, S.Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
  • Miano M; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
  • Motta I; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Pinto VM; University of Mannheim, Mannheim, Germany.
  • Piperno A; Istituto Giannina Gaslini, Genoa, Italy.
  • Mariani R; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
  • Putti MC; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Quota A; E.O. Ospedali Galliera, Genoa, Italy.
  • Ribersani M; Azienda Ospedale Università Padova, Padua, Italy.
  • Marziali M; Azienda Ospedale Università Padova, Padua, Italy.
  • Roberti D; UOS Talassemia P.O. Vittorio Emanuele, Gela (Caltanissetta), Italy.
  • Rosso R; Policlinico Umberto I, Rome, Italy.
  • Tartaglione I; Azienda Ospedaliero-Universitaria Policlinico "Vittorio Emanuele", Catania, Italy.
  • Vitucci A; Azienda Ospedaliera Universitaria Policlinico, Bari, Italy.
  • Voi V; Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
  • Zecca M; Policlinico GB Rossi, Verona, Italy.
  • Romero R; Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
  • Marouneld C; Emergency Department, Hospital Universitario Getafe, Getafe (Madrid), Spain.
  • Fernández-Rozas I; Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
  • Espejo C; Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Marhaeni W; HOSPITAL UNIVERSITARIO LA PAZ, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
  • Garcia Aguado M; Hospital Universitario Severo Ochoa, Cardiology, LeganÃ, Spain.
  • Cappellini MD; Hospital Universitario PrÃncipe de Asturias, Madrid, Spain.
  • Perrotta S; Pediatrics Department, Hematology-Oncology Division, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia.
  • De Franceschi L; Cardiology Department, Hospital Puerta de Hierro de Majadahonda, Majadahonda, Madrid, Spain.
  • Piga A; Department of Cardiology, BG Universitätsklinikum Bochum, Ruhr-Universität Bochum, Bochum, Germany.
  • Forni GL; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
  • Akin I; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
J Cell Mol Med ; 26(9): 2520-2528, 2022 05.
Article in English | MEDLINE | ID: covidwho-1769729
ABSTRACT
Although numerous patient-specific co-factors have been shown to be associated with worse outcomes in COVID-19, the prognostic value of thalassaemic syndromes in COVID-19 patients remains poorly understood. We studied the outcomes of 137 COVID-19 patients with a history of transfusion-dependent thalassaemia (TDT) and transfusion independent thalassaemia (TIT) extracted from a large international cohort and compared them with the outcomes from a matched cohort of COVID-19 patients with no history of thalassaemia. The mean age of thalassaemia patients included in our study was 41 ± 16 years (48.9% male). Almost 81% of these patients suffered from TDT requiring blood transfusions on a regular basis. 38.7% of patients were blood group O. Cardiac iron overload was documented in 6.8% of study patients, whereas liver iron overload was documented in 35% of study patients. 40% of thalassaemia patients had a history of splenectomy. 27.7% of study patients required hospitalization due to COVID-19 infection. Amongst the hospitalized patients, one patient died (0.7%) and one patient required intubation. Continuous positive airway pressure (CPAP) was required in almost 5% of study patients. After adjustment for age-, sex- and other known risk factors (cardiac disease, kidney disease and pulmonary disease), the rate of in-hospital complications (supplemental oxygen use, admission to an intensive care unit for CPAP therapy or intubation) and all-cause mortality was significantly lower in the thalassaemia group compared to the matched cohort with no history of thalassaemia. Amongst thalassaemia patients in general, the TIT group exhibited a higher rate of hospitalization compared to the TDT group (p = 0.001). In addition, the rate of complications such as acute kidney injury and need for supplemental oxygen was significantly higher in the TIT group compared to the TDT group. In the multivariable logistic regression analysis, age and history of heart or kidney disease were all found to be independent risk factors for increased in-hospital, all-cause mortality, whereas the presence of thalassaemia (either TDT or TIT) was found to be independently associated with reduced all-cause mortality. The presence of thalassaemia in COVID-19 patients was independently associated with lower in-hospital, all-cause mortality and few in-hospital complications in our study. The pathophysiology of this is unclear and needs to be studied in vitro and in animal models.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thalassemia / Iron Overload / COVID-19 Type of study: Etiology study / Prognostic study / Risk factors Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: J Cell Mol Med Journal subject: Molecular Biology Year: 2022 Document Type: Article Affiliation country: Jcmm.17026

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thalassemia / Iron Overload / COVID-19 Type of study: Etiology study / Prognostic study / Risk factors Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: J Cell Mol Med Journal subject: Molecular Biology Year: 2022 Document Type: Article Affiliation country: Jcmm.17026