COVID-19 infection among pediatric patients with hemoglobinopathies in Basrah, Iraq

Abstract: BACKGROUND: Patients with hemoglobinopathies are considered as immunocompromised; however, it is unclear if they are more susceptible to COVID-19 infection and experience a more severe illness course. AIMS OF STUDY: The aims of this study were to evaluate the clinical presentation and severity of COVID-19 among pediatric patients with hemoglobinopathies, assess risk factors, and outcome among studied patients. PATIENTS AND METHODS: An analytical, cross-sectional study has been carried out on children and adolescents with hemoglobinopathies, for the period from the first of May 2021 to September 2022. In addition to patient’s data and thorough physical examination, patients were followed concerning the course, complications, and disease outcome. Investigations included complete blood count, inflammatory markers, liver, and renal function tests. RESULTS: Out of 42 patients with hemoglobinopathies and COVID-19, the majority of patients 35 (83.3%) gave a history of COVID-19 exposure, with a median of 5 days for the presentation since exposure and 23 (54.8%) needed hospitalization. All studied patients had fever, followed by cough in 36 (85.7%) and shortness of breath (42.9%). No death was reported in studied patients. The lymphocyte count was significantly lower and C-reactive protein and D-dimer levels were significantly higher in sickle cell disease (SCD) patients with COVID-19 as compared to thalassemia patients, P < 0.05. Twenty-two patients (52.4%) had mild COVID-19 disease, 12 (28.6%) moderate, and 8 (19%) with severe disease. Regression analysis revealed that acute chest syndrome (ACS) as COVID-19 infection presentation, high white blood cells count, and elevated total serum bilirubin were significant variables associated with severe COVID-19 infection, P < 0.05. CONCLUSION: The clinical course of hemoglobinopathy patients with COVID-19 infection is similar to that in the general population and no death was reported among studied patients. However, clinicians treating patients with SCD need to be aware of COVID-19 infection when diagnosing ACS.