The following article features coverage from the European Hematology Association 2020 virtual meeting. Click here to read more of Hematology Advisor’s conference coverage.

 

Although the United Kingdom implemented shielding measures to reduce the risk of novel coronavirus disease 2019 (COVID-19) in vulnerable individuals, such as those with hemoglobinopathies, a survey by the National Hemoglobinopathy Panel revealed that many patients with hemoglobinopathies, predominantly those with sickle cell disease, have been infected with severe acute respiratory syndrome coronavirus 2.

The results were presented on behalf of the National Haemoglobinopathy Panel by Paul Telfer, MD, of Queen Mary University of London in the United Kingdom, at the European Hematology Association (EHA) Annual Congress.


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To evaluate the effect of shielding and to guide clinical management and public health policy, the investigators analyzed data from patients with COVID-19 that was collected weekly from April 8, 2020, to June, 5, 2020, by 10 regional hemoglobinopathy coordinating centers in England.

The 2 primary questions that the team sought to answer were (1) are patients with hemoglobinopathies and rare anemias more likely to experience adverse outcomes of COVID-19 and (2) what are the risk factors for adverse outcomes?

As of May 6, 2020, 195 COVID-19 cases (female, 109; adult, 175) were reported. Consistent with the general population, most patients with COVID-19 were adults (89%), and the median age was 33 years.

Most (84%) of cases were patients with sickle cell disease (SCD; HbSS, 63.6%; hemoglobin SCD, 15.4%, and other phenotypes, 5.2%), followed by those with thalassemia disorders (12.7%; transfusion dependent [TD], 10.2% and non-TD, 2.5%), and rare anemias (3.1%).

Overall, 74% of patients were admitted to the hospital. Of those, 10.5% were admitted to critical care (noninvasive ventilation, 7/143; mechanical ventilation, 4/143; both, 4/143).

Among the 168 individuals with a completed COVID-19 course, 92.3% recovered and 7.7% died (all adults), including 7 of 8 who received mechanical ventilation. As of May 6, 10.7% of cases in this study were still receiving inpatient treatment, including 1 patient remaining on mechanical ventilation.

Among adults who were hospitalized, the mortality rate was 9.8%, and of 13 deaths, 11 of those were individuals with SCD (85%). Of those who died, approximately 50% had comorbid conditions. No significant difference in mortality rate was observed between men (6.9%) and women (8.3%).

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“We feel that for [vulnerable] adults, with sickle cell in particular, isolation precautions should be lifted cautiously and that adults should be prioritized for new therapies and vaccinations when available,” concluded Dr Telfer.

Reference

Telfer P, De La Fuente J, Sohal M, et al. Real-time national survey of COVID-19 in hemoglobinopathy and rare inherited anemia patients. Presented at: Virtual Edition of the 25th European Hematology Association (EHA) Annual Congress; June 2020. Abstract LB2606