Virtual Care Reduced Illness, Death Due to COVID-19 for Patients With Sickle Cell Disease

As the pandemic wore on, fewer patients with sickle cell disease who did contract COVID-19 needed to be hospitalized.

A quick switch to virtual visits for routine follow-up care for more than 1300 patients with sickle cell disease (SCD) has been credited with reducing exposure, illness, and death due to COVID-19, according to a poster presented at the 63rd American Society of Hematology Meeting and Exposition.

The researchers reviewed data on patients from the Georgia Comprehensive Sickle Cell Center at Grady Hospital in Atlanta. Of a total of 1343 patients, only 55 (4%) contracted COVID-19, and they were tracked in the clinical database set up. At the onset of the pandemic, the center reported a drop in the number of patient visits as lockdown regulations took effect. As a result, the center adopted virtual visits to deliver health care to patients and also protect them against COVID-19 infection risk.

A slight majority of the patients with COVID-19 were female (51%), 16 patients (29%) were hospitalized, and 2 patients died from complications related to their infection. After 1 year of follow up, 11 patients had not needed hospitalization or emergency department treatment for complications of either COVID-19 or SCD.

“Our findings show that when supported by virtual visits, most of our patients successfully reduced their exposure to and complications from COVID-19,” study author Fuad El Rassi, MD, of Emory University and director of research at the Grady Comprehensive Sickle Cell Center, said in a statement. “They understood the risks and followed recommendations to stay at home and avoid interacting with other people.”

The most common COVID-19 signs and symptoms experienced were pain (58%), cough and fever (40%), dyspnea (31%), and pneumonia (25%). Nine of the patients with COVID-19 were treated with remdesivir, 8 with dexamethasone, and 7 with red cell products. Two patients were intubated after they developed acute respiratory distress syndrome.

The authors noted that “deaths occurred early in the course of the pandemic.” Of the 35 cases occurring from October 2020 to March 202, there were zero deaths. Furthermore, the number of hospitalizations decreased as the pandemic wore on and as better treatments for COVID-19 became available.

“Despite the second peak in COVID-19 cases in the winter of 2021, there were no reported deaths among our patients who developed the disease,” El Rassi added. “This suggests that the patients’ vigilance in staying home may have been crucial to reducing illness and death, and having the option for virtual visits was also key.”

Reference

El Rassi F, Abouyabis AN, Fasano RM, McLemore ML. COVID-19 infection and outcomes at a comprehensive sickle cell center. Presented at: 63rd American Society of Hematology Meeting and Exposition; December 11-14, 2021; Atlanta, Georgia, and virtual. Abstract 3105.