A new study shows that not all people with sickle cell disease have the same level of risk for severe COVID-19.

Researchers say that certain factors, such as history of pain episodes and coexisting organ conditions, are the driving factors leading to severe coronavirus disease, including the need for hospitalization.

What is sickle cell disease?

Sickle cell anemia It is a hereditary red blood cell disease, most commonly seen in blacks or Hispanics.

People with this disease inherit an abnormal type of hemoglobin in their red blood cells, called hemoglobin S, from their parents. When only one parent has the hemoglobin S gene, the child will have sickle cell characteristics, but usually does not suffer from this disease. However, they may pass it on to their children.

Hemoglobin is the protein in the blood that transports oxygen to other parts of the body. Hemoglobin S makes red blood cells hard and sickle-shaped. Their shape is not round, but crescent.

Sickle cells are sticky and can bind together, blocking blood flow and preventing oxygen from reaching the desired location in the body. This leads to a sudden onset of pain, called a pain crisis.

There are several different types of sickle cell disease. Hemoglobin SS, also called sickle cell anemia, is the most common and severe type of sickle cell disease.

Anemia occurs when red blood cells die faster than the body can replace them. Normal red blood cells can usually survive for 90 to 120 days. Sickle cells can only survive for 10 to 20 days. This short cycle of life and death is more difficult for the body to maintain.

Acute pain crisis, also called vascular occlusive crisis, may result in long-term hospitalization to control severe pain. Sickle red blood cells also begin to affect various organs, bones and joints.

Sickle cell disease and COVID-19

Previous research has shown that patients with COVID-19 and sickle cell disease are at greater risk of hospitalization compared to black people without sickle cell disease who are infected with the virus. However, according to this latest research, all people with inherited blood diseases are not necessarily at higher risk.

Study author Dr. Lana Mucalo of the Medical College of Wisconsin and her colleagues found that children and adults with sickle cell disease have previously suffered more than two painful events that require acute care, and that these two serious COVID-19 diseases are at risk Both are higher and hospitalized. The same is true for children with heart, lung, and kidney disease related to sickle cell disease.

Overall, children with a history of pain episodes are 2.2 times more likely to be hospitalized with COVID-19 than other children, and more than three times more likely to suffer from severe COVID-19 disease.

Adults with a history of painful events are 1.8 times more likely to be hospitalized due to COVID-19 and 1.9 times more likely to suffer from COVID-19 serious illness.

“This study tells us that all patients with sickle cell disease have different risk levels.“Mukalo Say. “Patients with a history of pain and patients with organ diseases need to be more careful to avoid COVID-19 infection than patients without any comorbidities. “

According to registered data, pain is the most common COVID-19 symptom for these children and adult patients. For many of them, pain is the only manifestation of COVID-19 disease.

“This means that sickle cell disease patients who come to the hospital should also be tested for COVID-19.“ Mukalo said.

Researchers also found that hydroxyurea is a commonly used drug for patients with sickle cell disease to reduce the frequency of pain episodes. It will not affect the severity of the COVID-19 disease or require hospitalization. However, patients taking it are less likely to experience pain during COVID-19 infection.

Mucalo said healthcare providers for sickle cell patients should recommend the COVID-19 vaccine to them, especially if they have coexisting organ diseases.

This Medical Research Advisory Committee It is also recommended that patients with sickle cell disease be vaccinated against COVID-19. Although the committee stated that patients should always discuss any potential personal risks with their doctor first.

The data for the study comes from SECURE-SCD, an international registry of volunteers, where sickle cell disease patients report COVID-19 infection, including details of severity and treatment. The researchers analyzed data from 750 children and adults who reported to the registry between March 2020 and March 2021.

Ninety percent of study participants identified as black and 7% were Hispanic or Latino. Half of the participants were children under 18 and half were adults. The median age of adults is 31 years.

The researchers pointed out that because registration is completely voluntary, the study cannot fully understand the COVID-19 infection of patients with sickle cell disease.The research is published in the journal Blood progression.