Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital
BackgroundCOVID-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 o...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.987194/full |
| _version_ | 1797903913451520000 |
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| author | Olufunke Y. Martin Deepika S. Darbari Deepika S. Darbari Stefanie Margulies Robert S. Nickel Robert S. Nickel Alexis Leonard Alexis Leonard Barbara Speller-Brown Barbara Speller-Brown Brenda Martin John R. Barber Jennifer Webb Jennifer Webb Suvankar Majumdar Suvankar Majumdar Matthew P. Sharron Matthew P. Sharron Andrew D. Campbell Andrew D. Campbell |
| author_facet | Olufunke Y. Martin Deepika S. Darbari Deepika S. Darbari Stefanie Margulies Robert S. Nickel Robert S. Nickel Alexis Leonard Alexis Leonard Barbara Speller-Brown Barbara Speller-Brown Brenda Martin John R. Barber Jennifer Webb Jennifer Webb Suvankar Majumdar Suvankar Majumdar Matthew P. Sharron Matthew P. Sharron Andrew D. Campbell Andrew D. Campbell |
| author_sort | Olufunke Y. Martin |
| collection | DOAJ |
| description | BackgroundCOVID-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.MethodsWe 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.ResultsA 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 (N = 40) of all patients required emergency department care or hospitalization. While 47% (N = 26) were hospitalized, only 5% (N = 3) of all patients required intensive care unit admission. Patients frequently had concurrent vaso-occlusive pain crisis (VOC) (N = 17, 43%) and acute chest syndrome (ACS) (N = 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%, p = 0.023).ConclusionChildren 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. |
| first_indexed | 2024-04-10T09:40:23Z |
| format | Article |
| id | doaj.art-0596c800673c48629b01843a1ae53d05 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-10T09:40:23Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-0596c800673c48629b01843a1ae53d052023-02-17T09:05:28ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-02-011010.3389/fmed.2023.987194987194Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospitalOlufunke Y. Martin0Deepika S. Darbari1Deepika S. Darbari2Stefanie Margulies3Robert S. Nickel4Robert S. Nickel5Alexis Leonard6Alexis Leonard7Barbara Speller-Brown8Barbara Speller-Brown9Brenda Martin10John R. Barber11Jennifer Webb12Jennifer Webb13Suvankar Majumdar14Suvankar Majumdar15Matthew P. Sharron16Matthew P. Sharron17Andrew D. Campbell18Andrew D. Campbell19Center for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesDepartment of Biostatistics and Study Methodology, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesDepartment of Pediatrics, The George Washington University School of Medicine, Washington, DC, United StatesCenter for Cancer and Blood Disorders, Division of Hematology, Children’s National Hospital, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Children’s National Hospital, Washington, DC, United StatesBackgroundCOVID-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.MethodsWe 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.ResultsA 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 (N = 40) of all patients required emergency department care or hospitalization. While 47% (N = 26) were hospitalized, only 5% (N = 3) of all patients required intensive care unit admission. Patients frequently had concurrent vaso-occlusive pain crisis (VOC) (N = 17, 43%) and acute chest syndrome (ACS) (N = 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%, p = 0.023).ConclusionChildren 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.https://www.frontiersin.org/articles/10.3389/fmed.2023.987194/fullsickle cell disease (SCD)COVID-19SARS-CoV-2pediatrics–childrenmorbiditymortality |
| spellingShingle | Olufunke Y. Martin Deepika S. Darbari Deepika S. Darbari Stefanie Margulies Robert S. Nickel Robert S. Nickel Alexis Leonard Alexis Leonard Barbara Speller-Brown Barbara Speller-Brown Brenda Martin John R. Barber Jennifer Webb Jennifer Webb Suvankar Majumdar Suvankar Majumdar Matthew P. Sharron Matthew P. Sharron Andrew D. Campbell Andrew D. Campbell Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital Frontiers in Medicine sickle cell disease (SCD) COVID-19 SARS-CoV-2 pediatrics–children morbidity mortality |
| 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 |
| title_full | Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital |
| title_fullStr | Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital |
| title_full_unstemmed | Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital |
| title_short | Clinical outcomes of children and adolescents with sickle cell disease and COVID-19 infection: A year in review at a metropolitan tertiary pediatric hospital |
| title_sort | clinical outcomes of children and adolescents with sickle cell disease and covid 19 infection a year in review at a metropolitan tertiary pediatric hospital |
| topic | sickle cell disease (SCD) COVID-19 SARS-CoV-2 pediatrics–children morbidity mortality |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.987194/full |
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