Sickle Cell Disease and Risk of Severe Illness or Death from COVID-19

Sickle Cell Disease and Risk of Severe Illness or Death from COVID-19

Patients with sickle cell disease (SCD) are immunocompromised and often have SCD-associated problems, such as pulmonary hypertension and chronic inflammation, that could lead to life-threatening outcomes following coronavirus infection. COVID-19’s effects on SCD patients and on people with sickle cell trait (SCT, in which one copy of the sickle cell gene and one normal gene are inherited) have not been well studied.

In a study published online on August 5 in Haematologica, Tim Duong, Ph.D., Wouter Hoogenboom, Ph.D., and colleagues describe results from one of the largest studies to date involving COVID-19’s impact on people with SCD or SCT. In collaboration with Deepa Manwani, M.B.B.S., and Parsa Mirhaji, M.D., Ph.D., the researchers used a new clinical research tool, called ATLAS, to analyze health records of 12,659 COVID-19 outpatients and inpatients cared for at 15 hospitals in the Montefiore Health System from January 1, 2020 to January 21, 2021. The goal was to determine whether SCD or SCT COVID-19 patients were more susceptible to critical illness and in-hospital mortality compared with COVID-19 patients from the Montefiore Health System’s general population.

SCD patients with COVID-19 were nearly 4 times more likely to have visited the emergency department and more than 7 times more likely to have been admitted to the hospital compared to the general population of COVID-19 patients matched for age, gender, race, ethnicity, and pre-existing conditions. But despite their high hospitalization rates, SCD patients with COVID-19 did not differ from COVID-19 patients in the general population with respect to mortality rate and likelihood of becoming critically ill due to COVID-19. Similarly, SCT patients also had no increased risk for worse COVID-19-related outcomes compared with the people in the general population with the disease.

Dr. Duong is professor and vice chair for research of radiology, professor of physiology & biophysics, and professor in the Dominick P. Purpura Department of Neuroscience at Einstein. Dr. Hoogenboom is a research fellow in the department of radiology at Einstein. Dr. Manwani, M.B.B.S., is professor of pediatrics at Einstein and is director of hematology in the department of pediatrics at Montefiore. Dr. Mirhaji is a research associate professor of systems & computational biology at Einstein and director of the Montefiore Einstein Center for Health Data Innovations.