Patients with sickle cell disease (SCD) are at an increased risk of hospitalization and death after COVID-19 infection, according to research published in the Journal of Pediatric Hematology/Oncology. People with SCD are encouraged to receive vaccination against SARS-CoV-2 and to avoid infection where possible.
Early in the COVID-19 pandemic, people with SCD were identified as high-risk groups for mortality. These decisions were based on hospital data suggesting an increased risk of death, rather than from the wider, non-hospitalized SCD population.
Consequently, the association between newborn SCD presence and risk of hospitalization and death after COVID-19 infection is not well described.
For this study, researchers analyzed data from 2 states — Michigan and Georgia — to determine any link between SCD or sickle cell trait and COVID-19 hospitalization or death, as compared with the general population.
Overall, data were included from 70,394 patients with a confirmed COVID-19 infection born in Georgia between 2008 and 2020, and 329,555 patients born in Michigan between 1987 and 2019. In Georgia, 147 patients had SCD whereas 2297 had sickle cell trait; in Michigan, 245 patients had SCD while 4165 had sickle cell trait. The remaining patients in both states had normal hemoglobin.
Analysis showed that SCD was linked with a significantly higher risk of COVID-19-related hospitalization (adjusted odds ratio [OR] in Georgia, 20.2; 95% CI, 13.6-30; adjusted OR in Michigan, 14.8; 95% CI, 10.4-21.1). No significant difference was noted between patients with sickle cell trait and the normal hemoglobin population.
The overall mortality risk was, furthermore, higher among patients with SCD (adjusted OR, 11.2; 95% CI, 3.4-37.3), though not among patients with sickle cell trait.
“These data and analyses are however the first large-scale, population-based look at SCD, traits, and COVID-19, and as such add significantly to what is known about these conditions when comorbid,” the authors wrote in their report. “It should reinforce the health care providers’ need to increase vaccination rates, which may be limited by families with vaccine hesitancy.”
Paulukonis ST, Snyder A, Smeltzer MP, et al. COVID-19 infection and outcomes in newborn screening cohorts of sickle cell trait and sickle cell disease in Michigan and Georgia. J Pediatr Hematol Oncol. 2023;45(4):174-180. doi:10.1097/MPH.0000000000002671