Contributions
Abstract: PB1804
Type: Publication Only
Session title: Thalassemias
Background
Healthcare systems around the globe are still facing the evolving threat of the corovavirus-19 (COVID-19) pandemic. Hemoglobinopathies include a group of genetic disorders, with the two main pillars being thalassemias and sickle cell disease (SCD). Due to their immunocompromised status, such patients (pts) have been protected as extremely vulnerable to COVID-19 infection. Despite limited data in literature, recent reports present conflicting results
Aims
We prospectively investigated the incidence and outcomes of COVID-19 in pts with hemoglobinopathies and correlated them to their coexistent comorbidities.
Methods
We studied pts with different hemoglobinopathies, consecutively monitored at our Center, who were infected with SARS-COV 2 during the first and second “waves” of the pandemic in Greece (March - December 2020). The following factors were studied: age, employment, blood type, liver and heart hemosiderosis, splenectomy, concomitant endocrine disorders and transfusion dependency.
Results
Among 250 pts regularly followed-up at our Center (7 with HbH hemoglobinopathy 150 with Thalassemia major, 53 with SCD and 41 with non transfusion dependent thalassemia), 9 (3.4%) were infected with COVID-19 (5 male: 4 female). COVID-19 pts’ age range was 20-46 (median 35.1). During the same time period the prevalence of COVID-19 infection in Greece’s general population, regarding the same age groups, was 1.89%. Two pts had HbH hemoglobinopathy, 1 Sickle Cell Disease (SCD), and 6 transfusion dependent β-thalassemia (TDT). In total, 7/9 pts were transfusion dependent (TD). Blood type was A+ in 55.5%, B+ in 11.1%, AB+ in 11.1% and O+ in 22.2% of pts. The range of ferritin levels at the time of infection was 180-992 ng/ml (median 434). Seven out of 9 pts had median MRI T2* liver iron concentration (LIC) of 1.696 g/dw and median MRIT2* of the heart 33.7 tms. However, their ejection fracture (EF) was >50% at all cases. Two pts were splenectomized and 1 had functional asplenia. Only 2 pts had concomitant endocrine disorders (hypothyroidism and hypogonadism). These pts were on hormone replacement therapy. All TD pts were on iron chelation therapy (5 on deferasirox and 1 on both deroxamine and deferiprone). Three pts were healthcare employees.Six out of 9 pts required hospitalization for a median time of 5.8 days (1 with HbH, 1 with SCD during crisis and 4 with TDT), but no one required Intensive Care Unit (ICU) monitoring, intubation or intensive ventilation support. All pts presented with fever (3 with febrile neutropenia), while 2 TDT pts had ground-glass opacities. All hospitalized pts received wide-range antibiotics plus azithromycin (as did 1 TDT pt who stayed at home). Heparin was administered in the SCD pt and in 1 of the TDT pts. One pt with HbH also received hydroxychloroquine and 1 with TDT dexamethasone. At the end of follow-up (median of 3.5 months, range 1.2-4.2), all pts are alive. On the contrary, mortality of the general Greek population in the same age group and time period was 1%.
Conclusion
Our real-world data suggest that the prevalence of COVID-19 in pts with hemoglobinopathies is slightly increased compared to the general population. Considering that these pts are more strictly monitored, we could hypothesize that self-applied precautions are effective. No death or severe pulmonary disease requiring intubation was observed. In compliance with recent data, our findings do not indicate increased mortality and morbidity of COVID-19 in pts with hemoglobinopathies, followed in a Specialized Center. However, more data are needed for a safe conclusion to be extracted.
Keyword(s): COVID-19, Hemoglobinopathy, Sickle cell disease, Thalassemia
Abstract: PB1804
Type: Publication Only
Session title: Thalassemias
Background
Healthcare systems around the globe are still facing the evolving threat of the corovavirus-19 (COVID-19) pandemic. Hemoglobinopathies include a group of genetic disorders, with the two main pillars being thalassemias and sickle cell disease (SCD). Due to their immunocompromised status, such patients (pts) have been protected as extremely vulnerable to COVID-19 infection. Despite limited data in literature, recent reports present conflicting results
Aims
We prospectively investigated the incidence and outcomes of COVID-19 in pts with hemoglobinopathies and correlated them to their coexistent comorbidities.
Methods
We studied pts with different hemoglobinopathies, consecutively monitored at our Center, who were infected with SARS-COV 2 during the first and second “waves” of the pandemic in Greece (March - December 2020). The following factors were studied: age, employment, blood type, liver and heart hemosiderosis, splenectomy, concomitant endocrine disorders and transfusion dependency.
Results
Among 250 pts regularly followed-up at our Center (7 with HbH hemoglobinopathy 150 with Thalassemia major, 53 with SCD and 41 with non transfusion dependent thalassemia), 9 (3.4%) were infected with COVID-19 (5 male: 4 female). COVID-19 pts’ age range was 20-46 (median 35.1). During the same time period the prevalence of COVID-19 infection in Greece’s general population, regarding the same age groups, was 1.89%. Two pts had HbH hemoglobinopathy, 1 Sickle Cell Disease (SCD), and 6 transfusion dependent β-thalassemia (TDT). In total, 7/9 pts were transfusion dependent (TD). Blood type was A+ in 55.5%, B+ in 11.1%, AB+ in 11.1% and O+ in 22.2% of pts. The range of ferritin levels at the time of infection was 180-992 ng/ml (median 434). Seven out of 9 pts had median MRI T2* liver iron concentration (LIC) of 1.696 g/dw and median MRIT2* of the heart 33.7 tms. However, their ejection fracture (EF) was >50% at all cases. Two pts were splenectomized and 1 had functional asplenia. Only 2 pts had concomitant endocrine disorders (hypothyroidism and hypogonadism). These pts were on hormone replacement therapy. All TD pts were on iron chelation therapy (5 on deferasirox and 1 on both deroxamine and deferiprone). Three pts were healthcare employees.Six out of 9 pts required hospitalization for a median time of 5.8 days (1 with HbH, 1 with SCD during crisis and 4 with TDT), but no one required Intensive Care Unit (ICU) monitoring, intubation or intensive ventilation support. All pts presented with fever (3 with febrile neutropenia), while 2 TDT pts had ground-glass opacities. All hospitalized pts received wide-range antibiotics plus azithromycin (as did 1 TDT pt who stayed at home). Heparin was administered in the SCD pt and in 1 of the TDT pts. One pt with HbH also received hydroxychloroquine and 1 with TDT dexamethasone. At the end of follow-up (median of 3.5 months, range 1.2-4.2), all pts are alive. On the contrary, mortality of the general Greek population in the same age group and time period was 1%.
Conclusion
Our real-world data suggest that the prevalence of COVID-19 in pts with hemoglobinopathies is slightly increased compared to the general population. Considering that these pts are more strictly monitored, we could hypothesize that self-applied precautions are effective. No death or severe pulmonary disease requiring intubation was observed. In compliance with recent data, our findings do not indicate increased mortality and morbidity of COVID-19 in pts with hemoglobinopathies, followed in a Specialized Center. However, more data are needed for a safe conclusion to be extracted.
Keyword(s): COVID-19, Hemoglobinopathy, Sickle cell disease, Thalassemia