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Higher COVID-19 Mortality for SCD

A recent post on the Centers for Disease Control and Prevention (CDC) website offered a warning that COVID-19 patients who also have Sickle Cell Disease (SCD) face more complications than the general population. The CDC cited a two-month study conducted by the Medical College of Wisconsin that found the rates of hospitalization, ICU admittance and death are much higher than average for COVID-19 patients with SCD.

Previous studies have shown that patients with SCD tend to have higher hospitalization rates and complications with influenza than the general population in the United States. This is due to the hard, sickle-shaped red blood cells clogging blood vessels and negatively affecting nearly every organ in the body.

With the arrival of the novel coronavirus in late 2019 and its subsequent spread worldwide in early 2020, it was an unanswered question as to whether SCD patients had similar risks with COVID-19 as they did with influenza. The Medical College of Wisconsin used the SECURE-SCD Registry to collect data on COVID-19 cases occurring globally in persons having SCD. From March 20 through May 21, 2020, 178 people with SCD in the United States were reported to the registry. Only confirmed COVID-19/SCD cases were reported; those with Sickle Cell Trait (SCT) and those with SCD but no confirmed COVID-19 test were not included.

In this two-month study, 178 COVID-19/SCD patients were reported to the registry and each patient’s outcome was tallied. These patients ranged in age from less than one year old to 69 years old, with an average age of 28.6 years old. Of the 178 patients, 122 (69%) were hospitalized, 19 (11%) were admitted to the ICU and 13 (7%) died.

These percentages of hospitalization, ICU admittance and death are much greater in the SCD patient community than in the general population. For example, in the general population of the United States, a death rate of less than 1% is seen in patients from 20 to 54 years of age. Hospital and ICU admittance rates are also lower in the general population than that of the SCD community. 

These heightened percentages, especially in a cohort with an average age of less than 29 years old, indicate that, along with the already known risks, SCD patients must take extra precautions to avoid or limit exposure to the virus that causes COVID-19.