Patients with transfusion-dependent thalassemia (TDT) were found to experience mild or asymptomatic presentations of COVID-19 in a study with findings reported in the journal Cureus.

In this study, patients with TDT also showed an immunoglobulin G (IgG) response to SARS-CoV-2 that was comparable to that of control individuals. “However, the serological response cannot sustain over three to six months as they have a more rapid fall in antibody titers when compared to the control group,” they wrote in their report.

The study included patients with COVID-19, based on test positivity during the prior 6 weeks, who were seen at a tertiary care center. Patients included in analyses either were individuals with TDT or control individuals without thalassemia, with the 2 groups matched by age and sex.

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The primary study outcome was an analysis of IgG antibody levels and COVID-19 clinical profiles. The secondary outcome was evaluation of the relationship between COVID-19 severity and IgG levels. Patients in this study were followed for 24 weeks.

There were 30 patients in each patient group. Patients with TDT had a mean age of 12.7 years (SD, 4.7), and the control group had a mean age of 13.9 years (SD, 7). There were 12 patients among those with TDT who demonstrated symptomatic COVID-19, compared with 22 patients in the control group (P =.009). Asymptomatic infections were reported for 18 patients among those with TDT and 8 patients in the control group.

Symptomatic COVID-19 was considered mild across both patient groups, among those with symptoms. In patients with TDT, the most common symptom was cough, whiel in the control group, fever was the most common symptom. Patients with symptomatic COVID-19 reportedly had a mean duration of illness of 5 days (SD, 1.6) among those with TDT, compared with 4 days (SD, 1.5) among those in the control group.

When measured at 6 weeks, median IgG titers did not show a statistically significant difference between patients with TDT and those from the control group (P =.40). Both the patients with TDT and the control group showed decreases in IgG titers over the course of the study.

However, by 12 weeks, patients with TDT demonstrated a significantly lower median IgG titer (P =.01) than the control group did, and this also was the case at 24 weeks (P =.006). COVID-19 severity did not seem to be associated with IgG titers or pre-existing comorbidities that were reported.

The researchers concluded that most patients with TDT in this study had mild or asymptomatic COVID-19, in addition to an IgG response that was not significantly different from that of the control group. However, they also concluded that patients with TDT showed a greater decline in serological response over time than the control group did, highlighting the importance of vaccination for these patients.


Kumari N, Gomber S, Dewan P, Narang S, Ahmed R. COVID-19 antibody response in patients with thalassemia. Cureus. 2023;15(6):e40567. doi:10.7759/cureus.40567