Sickle Cell Disease Confers Higher COVID-19 Mortality, Hospitalisation Risk

December 9, 2020

By Walter Alexander

NEW YORK -- December 8, 2020 -- Compared with the general black population in California, black patients with sickle cell disease who became infected with coronavirus disease 2019 (COVID-19) have higher rates of COVID-19 death, according to a study presented at the Virtual 2020 Annual Meeting of the American Society of Hematology (ASH).

Respiratory viral infections are a source of morbidity and mortality among patients with sickle cell disease, and these individuals are more likely than the general population to be hospitalised for an influenza infection.

Drawing on data from the SECURE-SCD Registry, the California Department of Public Health, and the COVID-19-Associated Hospitalization Surveillance Network, Lana Mucalo, MD, Medical College of Wisconsin, Milwaukee, Wisconsin, and colleagues calculated the hospitalisation and case fatality rates for individuals with sickle cell disease by specific age groups and contrasted them with the rates available publicly for the general black population in the United States.

Analysis of 324 patients with sickle cell disease and COVID-19 revealed a case fatality rate of 2.6% in those aged 18 to 34 years and 11.9% among those aged 35 to 50 years -- higher than the 0.4% and 1.0% rates, respectively, among the general black population for both age groups. Hospitalisation rates in patients aged 0 to 4 years were 7-fold higher (4.2% vs 0.6%) among those with sickle cell disease compared with the general black population.

Hospitalisation rates were far higher among black children with sickle cell disease who tested positive for COVID-19 and had pulmonary hypertension or acute chest syndrome (odds ratio [OR] = 4.173; P = .004) or had ≥3 emergency visits or hospitalisations for pain in the last 3 years (OR = 4.641; P = .006). Acute care for pain was also associated with a more severe disease course (OR = 3.964; P = .03) among children with sickle cell disease and COVID-19. N

“In particular, young adults and children with sickle cell disease are at higher risk for severe COVID-19 infection and hospitalisation than the general population,” said Dr. Mucalo. “That means they should be following recommended precautions, such as mask wearing, and their healthcare providers should be aware that they are at increased risk of severe illness.”

[Presentation title: Hospitalization and Case Fatality in Individuals With Sickle Cell Disease and COVID-19 Infection. Abstract 16]