AUTHOR=Martin Olufunke Y. , Darbari Deepika S. , Margulies Stefanie , Nickel Robert S. , Leonard Alexis , Speller-Brown Barbara , Martin Brenda , Barber John R. , Webb Jennifer , Majumdar Suvankar , Sharron Matthew P. , Campbell Andrew D. 

TITLE=Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.987194

DOI=10.3389/fmed.2023.987194

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>COVID-19 was declared a global pandemic in March 2020. Early reports were primarily in adults, and sickle cell disease (SCD) was classified as a risk factor for severe COVID-19 disease. However, there are a limited number of primarily multi-center studies reporting on the clinical course of pediatric patients with SCD and COVID-19.</p></sec><sec><title>Methods</title><p>We conducted an observational study of all patients with SCD diagnosed with COVID-19 at our institution between March 31, 2020, and February 12, 2021. Demographic and clinical characteristics of this group were collected by retrospective chart review.</p></sec><sec><title>Results</title><p>A total of 55 patients were studied, including 38 children and 17 adolescents. Demographics, acute COVID-19 clinical presentation, respiratory support, laboratory findings, healthcare utilization, and SCD modifying therapies were comparable between the children and adolescents. Seventy-three percent (<italic>N</italic> = 40) of all patients required emergency department care or hospitalization. While 47% (<italic>N</italic> = 26) were hospitalized, only 5% (<italic>N</italic> = 3) of all patients required intensive care unit admission. Patients frequently had concurrent vaso-occlusive pain crisis (VOC) (<italic>N</italic> = 17, 43%) and acute chest syndrome (ACS) (<italic>N</italic> = 14, 35%). Those with ACS or an oxygen requirement had significantly higher white blood cell count, lower nadir hemoglobin, and higher D-dimers, supporting a pro-inflammatory and coagulopathic picture. Non-hospitalized patients were more likely to be on hydroxyurea than hospitalized patients (79 vs. 50%, <italic>p</italic> = 0.023).</p></sec><sec><title>Conclusion</title><p>Children and adolescent patients with SCD and acute COVID-19 often present with ACS and VOC pain requiring hospital-level care. Hydroxyurea treatment appears to be protective. We observed no mortality despite variable morbidity.</p></sec>