A A Multicentre ICET-A Study of Confirmed SARS-CoV-2 Infection in Patients with Hemoglobinopathies: Preliminary Data from 10 Countries

Abstract

Objectives: This study aims to investigate, retrospectively, the epidemiological and clinical characteristics, laboratory results, radiologic findings and outcomes of novel coronavirus disease-19 (COVID-19) in patients with transfusion dependent β thalassemia (β-thalassemia major-TM), non-transfusion dependent β thalassemia (β-thalassemia intermedia -TI) and sickle cell disease (SCD). Design, setting: A total of 17 Centers, from 10 countries, following 9,499 patients with hemoglobinopathies participated in the survey. Main outcome measures: Clinical, laboratory and radiologic findings and outcomes of patients with COVID-19 were collected from medical records and summarized. Results: A total of 13 patients, 7 with TM, 3 with TI and 3 with SCD, with confirmed COVID-19, were identified from 6 Centers from different countries. The overall mean age of patients was 33.7±12.3 years (range:13-66); 9/13 (69.2%) patients were females. The commonest symptoms in the 10 symptomatic patients were: fever (80%), cough (70%), headache (60%), fatigue (60%), gastrointestinal symptoms (diarrhea /vomiting/abdominal pain; 50%), tachypnea/dyspnea (40%), and sore throat (40%). Six patients had pneumonia (unilateral, bilateral or multiple opacity) and 4 needed oxygen therapy. An oxygen saturation ≤ 93% was documented in 3 patients at diagnosis. 6/10 patients had an exacerbation of anemia (2 with SCD, associated with back and chest pain in 1 patient), and 3 (<30%) had a decreased absolute number of lymphocytes. Increased C-reactive protein and D-dimers were the most common laboratory findings (66.6 %). Conclusions: The clinical presentation for COVID-19 in patients with β-thalassemia and SCD varies. Patients with mild/ordinary COVID-19 infection appear to have clinical symptoms and laboratory findings common to other viral respiratory infections. One 30 year old TM female patient with diabetes and chronic kidney disease. For a better understanding of COVID-19 in patients with hemoglobinopathies, further epidemiologic and clinical studies in a larger cohort of patients are required.