Patients with hemoglobinopathy have a higher mortality rate from infection with COVID-19 than the general population, and people who also have cardiovascular or respiratory comorbidities may be at even higher risk of death, according to research published in Frontiers in Medicine.

The systematic review evaluated clinical presentations, lab and radiological findings, and outcomes of patients with hemoglobinopathy and COVID-19. The final review included 31 articles and 246 patients. Of the included patients, 140 had sickle cell anemia, 22 had sickle cell trait, 68 had transfusion-dependent thalassemia, and 16 had non-transfusion dependent thalassemia.

Respiratory and cardiovascular comorbidities were independently associated with morality from COVID-19 in these patients. Patients with respiratory comorbidities had 89.63 times the risk of death than patients without (P =.014). Patients with cardiovascular comorbidities had 35.20 times the risk of death than patients without (P =.035).

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In this analysis, 35.8% of patients with hemoglobinopathy had severe COVID-19 compared with about 11% to 19% of the general population. Patients in the study had a mortality rate of 6.9%, compared with estimates of 2% to 5% in the general public.

Patients with hemoglobinopathy had similar symptoms of COVID-19 to the general population, with fever and cough being the most commonly reported. A total of 28 articles encompassing 93 patients had data on treatments offered to patients. The treatment and management for COVID-19 in these patients was similar to that of the general population.

The study is limited by the fact that the included studies were published early in the pandemic and were case reports or case series or had small sample sizes. No long-term follow up was available for patients to monitor the effects of COVID-19 in patients with hemoglobinopathy.

Overall, clinical presentation and lab findings were similar in patients with hemoglobinopathy and those without. Patients with hemoglobinopathy had higher mortality than the general population, and those with coexisting cardiovascular or respiratory comorbidities should be treated with greater caution.


Lee JX, Chieng WK, Lau SCD, Tan CE. COVID-19 and hemoglobinopathies: a systematic review of clinical presentations, investigations, and outcomes. Front Med (Lausanne). 2021;8:757510. doi:10.3389/fmed.2021.757510