Comorbidities are risk factors for hospitalization and serious COVID-19 illness in children and adults with sickle cell disease.
Comorbidities are risk factors for hospitalization and serious COVID-19 illness in children and adults with sickle cell disease.
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DOI：
10.1182/bloodadvances.2021004288
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发表时间：
2021-07-13
期刊：
影响因子：
7.5
通讯作者：
Panepinto JA
中科院分区：
文献类型：
--
作者：
Mucalo L;Brandow AM;Dasgupta M;Mason SF;Simpson PM;Singh A;Taylor BW;Woods KJ;Yusuf FI;Panepinto JA
患有SCD且有疼痛史以及肾脏和心脏/肺合并症的儿童，其COVID-19结局恶化的风险更高。有疼痛史的成人SCD患者发生COVID-19结局恶化的风险更高。镰状细胞病（SCD）患者发生严重感染的风险很高，因此，了解严重急性呼吸综合征冠状病毒2型感染对这一人群的影响很重要。我们试图确定与SCD儿童和成人住院和严重COVID-19疾病相关的因素。我们建立了国际SECURE-SCD注册中心，以收集SCD和COVID-19疾病患者的数据。我们使用多变量logistic模型来估计年龄、性别、基因型、羟基脲、SCD相关和非相关合并症对住院、严重COVID-19疾病以及COVID-19疾病期间疼痛作为一种表现症状的独立影响。截至2021年3月23日，登记处共收到750例SCD患者的COVID-19病例报告。我们确定疼痛史（相对危险度[RR]，2.15; P < .0001）和SCD心/肺合并症（RR，1.61; P = .0001）是儿童住院的危险因素。疼痛史（RR，1.78; P = .002）也是成人住院的危险因素。有疼痛史（RR，3.09; P = .009）、SCD心/肺合并症（RR，1.76; P = .03）和SCD肾合并症（RR，3.67; P < .0001）的儿童和有疼痛史（RR 1.94，P = .02）的成人发生严重COVID-19疾病的风险较高。疼痛史和SCD肾脏合并症也增加了儿童在COVID-19期间疼痛的风险;疼痛史、SCD心脏/肺合并症和女性增加了成人在COVID-19期间疼痛的风险。羟基脲对住院和COVID-19严重程度没有影响，但它降低了COVID-19期间成人出现疼痛的风险。
Children with SCD with history of pain and renal and heart/lung comorbidities are at higher risk of worse COVID-19 outcomes. Adults with SCD with history of pain are at higher risk of worse COVID-19 outcomes. Patients with sickle cell disease (SCD) are at high risk of developing serious infections, therefore, understanding the impact that severe acute respiratory syndrome coronavirus 2 infection has on this population is important. We sought to identify factors associated with hospitalization and serious COVID-19 illness in children and adults with SCD.We established the international SECURE-SCD Registry to collect data on patients with SCD and COVID-19 illness. We used multivariable logistic models to estimate the independent effects of age, sex, genotype, hydroxyurea, and SCD-related and -nonrelated comorbidities on hospitalization, serious COVID-19 illness, and pain as a presenting symptom during COVID-19 illness. As of 23 March 2021, 750 COVID-19 illness cases in patients with SCD were reported to the registry. We identified history of pain (relative risk [RR], 2.15; P < .0001) and SCD heart/lung comorbidities (RR, 1.61; P = .0001) as risk factors for hospitalization in children. History of pain (RR, 1.78; P = .002) was also a risk factor for hospitalization in adults. Children with history of pain (RR, 3.09; P = .009), SCD heart/lung comorbidities (RR, 1.76; P = .03), and SCD renal comorbidities (RR, 3.67; P < .0001) and adults with history of pain (RR 1.94, P = .02) were at higher risk of developing serious COVID-19 illness. History of pain and SCD renal comorbidities also increased risk of pain during COVID-19 in children; history of pain, SCD heart/lung comorbidities, and female sex increased risk of pain during COVID-19 in adults. Hydroxyurea showed no effect on hospitalization and COVID-19 severity, but it lowered the risk of presenting with pain in adults during COVID-19.
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