The following article features coverage from the American Society of Hematology 2020 meeting. Click here to read more of Hematology Advisor‘s conference coverage.
Individuals with sickle cell disease (SCD) who acquire coronavirus disease 2019 (COVID-19) may have higher rates of death due to the disease, according to study results presented Lana Mucalo, MD, of the Medical College of Wisconsin in Milwaukee, at the virtual 62nd American Society of Hematology (ASH) Annual Meeting and Exposition. Study results also suggest that the rate of COVID-19 hospitalization in younger age groups is notably higher for the SCD population compared with the general Black population.
“Due to the current pandemic and potential future infectious disease epidemics, it is important to understand the effects that COVID-19 has on this medically vulnerable population,” said Dr Mucalo.
The objective of the study, which used data from the international Surveillance Epidemiology of Coronavirus Under Research Exclusion (SECURE) Registry of COVID-19 in individuals with SCD, was to characterize hospitalization and case fatality rates secondary to COVID-19 among individuals with SCD and compare these rates with those of the general Black population.
To ensure a rapid and larger volume of patient information, the data collected through the SECURE-SCD registry were deidentified and did not include protected health information patient data. Such data included patient demographics, COVID-19-related hospitalization, COVID-19 severity, disease management strategies, COVID-19-induced mortality, and information related to SCD complications. The investigators calculated hospitalization and case fatality rates for individuals with SCD according to specific age groups and compared those with the rates that are publicly available for the general Black population from COVID-NET (n=19,514).
In total, 366 individuals with SCD who had COVID-19 were reported in the registry: 152 children (46.7% female; mean age, 10.9 years; HbSS/HbSB0 genotype, 71.7%) and 214 adults (58.1% women; mean age, 34.0 years; HbSS/HbSB0 genotype, 72.0%). Rates of hospitalization and death were 46.1% and 0.7% in children and 66.8% and 7.0% in adults.
In the general Black population, case fatality rates were 0.0%, 0.4%, and 1.0% for age groups 0 to 17 years, 18 to 34 years, and 35 to 39 years, respectively, while case fatality rates for patients with SCD were 0.8%, 2.6%, and 11.9%, respectively.
Individuals with SCD were 6.2 times more likely to die due to COVID-19 compared with the general Black population. In addition, the peak case fatality rate occurred in patients in the 80+ years age group in the general Black population and in the 50 to 64 years and 65 to 79 years age groups in the SCD population.
Distribution of the hospitalization rate across age groups was also notable between the 2 populations. The hospitalization rate peaked at 65+ years in the general Black population compared with 18 to 49 years in the SCD population.
In a multivariate analysis, factors associated with hospitalization in children with SCD were acute care for pain (odds ratio [OR], 4.64; 95% CI, 1.97-10.9; P =.006), SCD heart/lung comorbidities (OR, 4.1; 95% CI, 1.56-11.15; P =.004), and neurobehavioral disorders (OR, 2.73; 95% CI, 1.09-6.81; P =.03).
“To conclude, individuals with sickle cell disease who have COVID infection have higher rates of death than the general population,” said Dr Mucalo.
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Mucalo L, Brandow AM, Mason SF, et al. Hospitalization and case fatality in individuals with sickle cell disease and COVID-19 infection. Presented at: American Society of Hematology (ASH) 62nd Annual Meeting and Exposition; December 5-8, 2020. Abstract 16.