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Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic

Authors
  • Alsayegh, Faisal1
  • Mousa, Shaker A.2
  • 1 Health Sciences Center, Kuwait University
  • 2 Albany College of Pharmacy and Health Sciences
Type
Published Article
Journal
Clinical and Applied Thrombosis/Hemostasis
Publisher
SAGE Publications
Publication Date
Sep 02, 2020
Volume
26
Identifiers
DOI: 10.1177/1076029620955240
PMID: 32873056
PMCID: PMC7476329
Source
PubMed Central
Keywords
License
Unknown

Abstract

The management of sickle cell disease (SCD) and its complications in the COVID-19 era is very challenging. The recurrent sickling process in SCD causes tissue hypoxemia and micro-infarcts, resulting in end organ damage. Since the outbreak of SARS-CoV-2 pandemic, little data has been published about SCD concerning clinical presentation with COVID-19 and management. Hydroxyurea has been the cornerstone of management in children and adults with SCD, with evidence of its effect on controlling end organ damage. There are several anti-sickling drugs that have been approved recently that might have an additive value toward the management of SCD and its complications. The role of simple and exchange transfusions is well established and should always be considered in the management of various complications. The value of convalescent plasma has been demonstrated in small case series, but large randomized controlled studies are still awaited. Immunomodulatory agents may play a role in reducing the damaging effects of cytokines storm that contributes to the morbidity and mortality in advanced cases. Prophylactic anticoagulation should be considered in every management protocol because SCD and COVID-19 are thrombogenic conditions. Management proposals of different presentations of patients with SCD and COVID-19 are outlined.

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