We’ve heard a lot about people who are at higher risk of COVID-19 complications, including the elderly and those with hypertension, diabetes, cardiovascular illness, and obesity. But there’s another group at high risk of developing serious medical complications if infected: sickle cell disease patients.
Sickle cell disease is an inherited blood condition that in the United States, primarily affects African-American people. As the CDC explains, healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body. In someone who has sickle cell disease, the red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle.’’ The sickle cells die early, which causes a constant shortage of red blood cells.
Hydroxyurea is a medication which helps the red blood cells stay round and flexible. If prescribed, patients should continue to take this and any other prescribed medications unless instructed otherwise by a medical provider.
Why are sickle cell patients at higher risk for complications with COVID-19?
People with sickle cell disease may have compromised immune systems, making them more at risk to infections. Other respiratory viruses are already known to have a potentially severe affect on sickle cell patients as they can potentially lead to acute chest syndrome, which can be a life threatening medical emergency. We suspect that COVID-19 could do the same.
How should sickle cell patients manage pain during the outbreak?
Pain is the most common complication of sickle cell disease, and the number 1 reason that people with the disease go to the emergency room or hospital. When sickle cells travel through small blood vessels, they can get stuck and clog the blood flow. This causes pain that can start suddenly, be mild to severe, and can last for any length of time.
Should a sickle cell patient go to the hospital right now with pain?
If you or your child has sickle cell pain and is not having fever, respiratory symptoms, or signs of infection, it’s best to avoid going to the hospital or emergency room right now and instead, manage pain at home with oral medications. If pain can not be controlled at home, please contact your physician. If you physician is unavailable , then going to the emergency room is appropriate.
What about patients experiencing COVID-19 symptoms, such as fever, cough or shortness of breath?
Make every effort to contact your doctor to be seen in a clinic setting immediately. Avoid the emergency department if possible. Seek medical care in the emergency department if you are unable to reach your doctor and need emergency medical services, including treatment for difficulty breathing, altered level of consciousness, turning blue, unresponsiveness, or any other concerning changes.
Be sure to discuss any recommended new medications with your doctor before taking them.
What about blood transfusions?
For sickle cell disease patients, a blood transfusion is used to provide normal red blood cells to the patient's body. Red blood cell transfusions help reduce anemia as well as the blood's “viscosity,” meaning transfusions allow the blood to flow more freely. Transfusions improve disease symptoms and can prevent complications.
If you are a sickle cell patient who receives blood transfusions, rest assured you should continue to receive them as usual and that they remain safe.
What can people do to help sickle cell patients?
All healthy people are encouraged to donate blood. You can help sickle cell patients – and many other patients – by giving the gift of life. Learn how to donate at the Ochsner Blood Bank.
Make an appointment with Corey Falcon, MD, pediatric hematologist/oncologist.