Impact of the coronavirus 2019 (COVID-19) on vasooclusive crisis in patients with sickle cell anaemia

Alkindi, S.; Elsadek, R. A.; Al-Madhani, A.; Al-Musalhi, M.; AlKindi, S. Y.; Al-Khadouri, G.; Al Rawahi, B.; Al-Ruqeishi, S.; Al-Yazeedi, J.; Wali, Y. A.; Al Shamakhi, S.; Al Rawahi, M.; Pathare, A. V.

Objectives The aim of this study was to assess the impact of COVID-19 on the morbidity and mortality on vasooclusive crisis (VOC) in sickle cell anaemia (SCA) patients. Methods One hundred patients with(fifty) or without COVID-19 PCR positivity(fifty), were enrolled in a prospective cohort study after signing a written informed consent. Results The COVID-19 positive patients had significantly higher median VOC episodes/year i.e 3 /year (IQR, 1-6 /year) v/s 2 /year (IQR, 2-12 /year) (p < 0.05) respectively, however the need for hospitalization was similar. There was a higher culture proven infection in COVID-19 negative group (P = 0.05). COVID-19 positive group had more osteonecrosis (p < 0.05), splenic sequestration, splenomegaly, and hepatic crisis (P values 0.05, 0.006 and 0.02 respectively). Symptoms of fever, cough, fatigue, abdominal pain and anosmia were significantly higher (p < 0.05) in the COVID-19 positive patients. Both cohorts, showed a fall in the mean haemoglobin, lymphocyte subset, platelets, and reticulocytes, whereas, the LDH and ferritin were significantly elevated. In SCA COVID-19 positive patients the rise in WBC, reticulocyte%, platelets, and ferritin was subdued (p < 0.05). Two died in COVID-19 positive, whereas three died in the COVID-19 negative, without statistically significant difference in mortality. Conclusions Although COVID-19 infection may have triggered the onset of VOC, it did not significantly influence the morbidity or mortality in this SCA cohort.