Sickle cell disease is an inherited disorder which results in deformation of the red blood cells into sickle or crescent shape, from the normal oval structure. This obstructs the blood vessels especially the small ones thus decreasing oxygen supply to the affected areas. This change in shape of the red cell is triggered by viral diseases, cold weather, stress and low oxygen supply. When the occluded blood vessels are in the lungs, this triggers a series of events leading to an Acute Chest Syndrome (ACS). ACS causes a decrease in oxygen supply to blood vessels causing more cells to become sickled and this further blocks the blood vessel; and the vicious cycle continues.
COVID-19 causes a respiratory infection and like other respiratory viruses can cause more severe complications in persons with SCD; resulting in increased hospitalisation, ACS and need for mechanical ventilation. It causes a pneumonia with acute respiratory distress syndrome and low-level oxygen; for which in SCD patients could trigger a vaso-occlusive crisis, for example ACS.
Given the limited knowledge of the corona virus and its effect on SCD patients, one cannot over-emphasize the need for prevention as a forefront measure in combatting the disease.
Most seasonal influenzas occur in the rainy season and are caused by viruses. These viruses increase the risk of hospitalisation and ACS in SCD patients.
The British Society of Haematology and British National Health Institute emphasize the increased risk of SCD patients to COVID-19 with an increase in the risk of ACS in this group of people. Recommending that those with stem cell transplant under two years and those on immunosuppressive drugs should shield themselves. Their proposed means of prevention include
- Virtual consultation if possible
- Postponing non-essential investigations
- Home delivery of necessary drugs
- Use of other antipyretics other than ibuprofen and other NSAIDs
- Staying at home and avoiding face to face contact.
Given the limited knowledge of the corona virus and its effect on SCD patients, one cannot over-emphasize the need for prevention as a forefront measure in combatting the disease. In our country where the prevalence of sickle cell is relatively higher than in Caucasians, the impact of the disease may be worse.