Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Alsayegh, Faisal, Mousa, Shaker A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476329/
https://www.ncbi.nlm.nih.gov/pubmed/32873056
http://dx.doi.org/10.1177/1076029620955240
_version_ 1783579684651401216
author Alsayegh, Faisal
Mousa, Shaker A.
author_facet Alsayegh, Faisal
Mousa, Shaker A.
author_sort Alsayegh, Faisal
collection PubMed
description 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.
format Online
Article
Text
id pubmed-7476329
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-74763292020-09-17 Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic Alsayegh, Faisal Mousa, Shaker A. Clin Appl Thromb Hemost Review 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. SAGE Publications 2020-09-02 /pmc/articles/PMC7476329/ /pubmed/32873056 http://dx.doi.org/10.1177/1076029620955240 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Alsayegh, Faisal
Mousa, Shaker A.
Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic
title Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic
title_full Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic
title_fullStr Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic
title_full_unstemmed Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic
title_short Challenges in the Management of Sickle Cell Disease During SARS-CoV-2 Pandemic
title_sort challenges in the management of sickle cell disease during sars-cov-2 pandemic
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476329/
https://www.ncbi.nlm.nih.gov/pubmed/32873056
http://dx.doi.org/10.1177/1076029620955240
work_keys_str_mv AT alsayeghfaisal challengesinthemanagementofsicklecelldiseaseduringsarscov2pandemic
AT mousashakera challengesinthemanagementofsicklecelldiseaseduringsarscov2pandemic