Double Trouble: COVID-19 Infection Exacerbates Sickle Cell Crisis Outcomes in Hospitalized Patients-Insights from National Inpatient Sample 2020

Overview

Journal Hematol Rep

Publisher MDPI

Date 2024 Jul 25

PMID 39051414

Authors

Zubair Hassan Bodla

Mariam Hashmi

Fatima Niaz

Austin B Auyeung

Anuoluwa Oyetoran

Muhammad Jahanzeb Khalil

Muhammad Salman Faisal

Farhan Khalid

Abdel-Rahman Zakieh

Yvette Bazikian

Christopher L Bray

Affiliations

Soon will be listed here.

Abstract

This study investigated the impact of COVID-19 on patients with sickle cell crisis (SCC) using National Inpatient Sample (NIS) data for the year 2020. A retrospective cohort analysis was conducted utilizing International Classification of Diseases (ICD-10) codes to identify adults who were admitted with a principal diagnosis of sickle cell crisis. The primary outcomes examined were inpatient mortality, while the secondary outcomes assessed included morbidity, hospital length of stay, and resource utilization. Analyses were conducted with STATA. Multivariate logistic and linear regression analyses were used to adjust for confounding variables. Of 66,415 adult patients with a primary SCC diagnosis, 875 were identified with a secondary diagnosis of COVID-19 infection. Unadjusted mortality rate was higher for SCC patients with COVID-19 (2.28%) compared to those without (0.33%), with an adjusted odds ratio (aOR) of 8.49 ( = 0.001). They also showed increased odds of developing acute respiratory failure (aOR = 2.37, = 0.003) and acute kidney injury requiring dialysis (aOR = 8.66, = 0.034). Additionally, these patients had longer hospital stays by an adjusted mean of 3.30 days ( < 0.001) and incurred higher hospitalization charges by an adjusted mean of USD 35,578 ( = 0.005). The SCC patients with COVID-19 presented higher mortality rates, increased morbidity indicators, longer hospital stays, and substantial economic burdens.

References

Vichinsky E, Neumayr L, Earles A, Williams R, Lennette E, Dean D . Causes and outcomes of the acute chest syndrome in sickle cell disease. National Acute Chest Syndrome Study Group. N Engl J Med. 2000; 342(25):1855-65. DOI: 10.1056/NEJM200006223422502. View

Hussain M, Syed S, Fatima M, Shaukat S, Saadullah M, Alqahtani A . Acute Respiratory Distress Syndrome and COVID-19: A Literature Review. J Inflamm Res. 2022; 14:7225-7242. PMC: 8710428. DOI: 10.2147/JIR.S334043. View

Payne A, Schieve L, Abe K, Hulihan M, Hooper W, Hsu L . COVID-19 and Sickle Cell Disease-Related Deaths Reported in the United States. Public Health Rep. 2022; 137(2):234-238. PMC: 8900241. DOI: 10.1177/00333549211063518. View

Payne A, Mehal J, Chapman C, Haberling D, Richardson L, Bean C . Trends in Sickle Cell Disease-Related Mortality in the United States, 1979 to 2017. Ann Emerg Med. 2020; 76(3S):S28-S36. PMC: 7598427. DOI: 10.1016/j.annemergmed.2020.08.009. View

Legrand M, Bell S, Forni L, Joannidis M, Koyner J, Liu K . Pathophysiology of COVID-19-associated acute kidney injury. Nat Rev Nephrol. 2021; 17(11):751-764. PMC: 8256398. DOI: 10.1038/s41581-021-00452-0. View

Ware R, De Montalembert M, Tshilolo L, Abboud M . Sickle cell disease. Lancet. 2017; 390(10091):311-323. DOI: 10.1016/S0140-6736(17)30193-9. View

Darbari D, Wang Z, Kwak M, Hildesheim M, Nichols J, Allen D . Severe painful vaso-occlusive crises and mortality in a contemporary adult sickle cell anemia cohort study. PLoS One. 2013; 8(11):e79923. PMC: 3818240. DOI: 10.1371/journal.pone.0079923. View

Menapace L, Thein S . COVID-19 and sickle cell disease. Haematologica. 2020; 105(11):2501-2504. PMC: 7604559. DOI: 10.3324/haematol.2020.255398. View

Bodla Z, Hashmi M, Niaz F, Farooq U, Khalid F, Tariq M . Independent predictors of mortality and 5-year trends in mortality and resource utilization in hospitalized patients with diffuse large B cell lymphoma. Proc (Bayl Univ Med Cent). 2024; 37(1):16-24. PMC: 10761168. DOI: 10.1080/08998280.2023.2267921. View

10.

Hoogenboom W, Alamuri T, McMahon D, Balanchivadze N, Dabak V, Mitchell W . Clinical outcomes of COVID-19 in patients with sickle cell disease and sickle cell trait: A critical appraisal of the literature. Blood Rev. 2021; 53:100911. PMC: 8605823. DOI: 10.1016/j.blre.2021.100911. View

11.

Nath K, Hebbel R . Sickle cell disease: renal manifestations and mechanisms. Nat Rev Nephrol. 2015; 11(3):161-71. PMC: 4701210. DOI: 10.1038/nrneph.2015.8. View

12.

Kato G, Piel F, Reid C, Gaston M, Ohene-Frempong K, Krishnamurti L . Sickle cell disease. Nat Rev Dis Primers. 2018; 4:18010. DOI: 10.1038/nrdp.2018.10. View

13.

Arlet J, De Luna G, Khimoud D, Odievre M, De Montalembert M, Joseph L . Prognosis of patients with sickle cell disease and COVID-19: a French experience. Lancet Haematol. 2020; 7(9):e632-e634. PMC: 7302791. DOI: 10.1016/S2352-3026(20)30204-0. View

14.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506. PMC: 7159299. DOI: 10.1016/S0140-6736(20)30183-5. View

15.

Hebbel R . Reconstructing sickle cell disease: a data-based analysis of the "hyperhemolysis paradigm" for pulmonary hypertension from the perspective of evidence-based medicine. Am J Hematol. 2011; 86(2):123-54. DOI: 10.1002/ajh.21952. View

16.

Pathare A, Al Kindi S, Alnaqdy A, Daar S, Knox-Macaulay H, Dennison D . Cytokine profile of sickle cell disease in Oman. Am J Hematol. 2004; 77(4):323-8. DOI: 10.1002/ajh.20196. View

17.

Bodla Z, Hashmi M, Niaz F, Farooq U, Khalid F, Abdullahi A . Timing matters: An analysis of the relationship between red cell transfusion timing and hospitalization outcomes in sickle cell crisis patients using the National Inpatient Sample database. Ann Hematol. 2023; 102(7):1669-1676. DOI: 10.1007/s00277-023-05275-6. View

18.

Rees D, Williams T, Gladwin M . Sickle-cell disease. Lancet. 2010; 376(9757):2018-31. DOI: 10.1016/S0140-6736(10)61029-X. View

19.

Singhania N, Bansal S, Nimmatoori D, Ejaz A, McCullough P, Singhania G . Current Overview on Hypercoagulability in COVID-19. Am J Cardiovasc Drugs. 2020; 20(5):393-403. PMC: 7398761. DOI: 10.1007/s40256-020-00431-z. View

20.

Hoban M, Cost G, Mendel M, Romero Z, Kaufman M, Joglekar A . Correction of the sickle cell disease mutation in human hematopoietic stem/progenitor cells. Blood. 2015; 125(17):2597-604. PMC: 4408287. DOI: 10.1182/blood-2014-12-615948. View