In a recent retrospective study of pregnant patients with sickle cell disease (SCD) who had COVID-19, most patients showed a typical presentation with SARS-CoV-2 infection. The study results were published in the Journal of Gynecology Obstetrics and Human Reproduction.
In their report, the researchers explained that some prior studies have shown a relatively mild clinical course and outcome with COVID-19 for patients with SCD, with the possible exception of patients having the HbSC genotype. However, they noted, conflicting information exists regarding the clinical course of SARS-CoV-2 infection in pregnant women who do not have comorbidities. “More information is therefore necessary to adapt healthcare during pregnancy for [patients] with SCD experiencing COVID-19,” they wrote. The objective of their study was to characterize features of SARS-CoV-2 infection in this patient population.
The study was conducted at Tenon Hospital in Paris, France. It included patients who were pregnant and had SCD who demonstrated COVID-19 positivity using a nasal-swab test administered by a practitioner between March 2020 and February 2021. Severity of the infection was the primary study endpoint, with pregnancy complications and fetal outcomes as secondary endpoints. Data regarding the COVID-19 clinical course were obtained through a combination of phone calls and follow-up appointments, as well as through hospital data in cases involving hospitalization.
The analysis included 8 pregnant patients who had SCD and tested positive for SARS-CoV-2 infection. The median age of the women in this study was 30.5 years. Most patients (87.5%) had experienced prior vaso-occlusive crises. A total of 6 patients (75%) had mild, common presentations of COVID-19, while 1 patient needed oxygen, and 1 patient was asymptomatic. The median duration of symptoms for this population was 5.5 days.
The patient requiring oxygen had been admitted to an intensive care unit, and she also underwent a cesarean section; she experienced a vaso-occlusive crisis, preeclampsia, and suspected acute chest syndrome. A vaso-occlusive crisis also occurred in another patient, but after COVID-19 remission, and this patient underwent induced labor.
Newborns in this study had a median Apgar score of 10 at 5 minutes after birth. The mean umbilical arterial blood pH at birth was considered normal, at 7.31 + 0.05. Newborns also had a median birth weight of 2770g (IQR, 2455-3545).
“In conclusion, in our study pregnant women with SCD mainly presented a mild form of COVID-19, independently of the genotype of SCD,” the study investigators wrote in their report. “COVID-19 impact on pregnancy outcomes was moderate and its course did not seem to differ from that reported in SCD-free patients.” The investigators also considered vaccination against COVID-19 to be important for pregnant patients with SCD.
Kolanska K, Vasileva R, Lionnet F, et al. Sickle cell disease and COVID-19 in pregnant women. J Gynecol Obstet Hum Reprod. 2022;51(3):102328. doi:10.1016/j.jogoh.2022.102328