Recent prenatal research data suggest that many sickle cell carriers may not view SCD as a severe disorder75; therefore, it is possible that individuals who have sickle cell trait may benefit from an improved awareness of sickle‐related complications, particularly during the COVID‐19 pandemic. Coronavirus and Sickle Cell Trait. Emerging trends in the United States suggest possibly higher mortality rates of COVID‐19 among African Americans, although detailed epidemiological study data is pending. You are strongly advised to work from home. If you are clinically extremely vulnerable, you will still have access to: If you need any additional support visit:, Find out more about the advice for those who are clinically extremely vulnerable, including guidance on work, employment rights, children and young people and more here: Learn more. Talk to them about how best to ensure you can continue to receive the care you need. As of May 16, 2020, 15 SCD patients with COVID‐19 have been reported in the clinical scientific literature indexed in PubMed.56 These studies are summarized in Table 1. However, below we have included all the available specific information there is and included the official guidance on avoiding catching or spreading germs and what to do if you need medical help, which all apply. COVID-19 is an illness that particularly affects the lungs and airways but can also affect the gut, kidneys, heart and brain . As highlighted by the medical literature, sickle cell trait potentially increases the risk(s) of hypercoagulability.30, 63-66 During intercurrent COVID‐19, this may lead to poor clinical outcomes. If you are taking hydroxycarbamide or iron chelators (drugs to remove excess iron) it is important these are continued. This will come as no surprise, Denominator matters in estimating COVID‐19 mortality rates, Explaining socioeconomic inequalities in self‐rated health: a systematic review of the relative contribution of material, psychosocial and behavioural factors, Genetic variation in IL28B (IFNL3) and response to interferon‐alpha treatment in myeloproliferative neoplasms, Genetics and ESKD disparities in African Americans, Molecular pathogenesis of acquired aplastic anemia, The genetic and molecular pathogenesis of myelodysplastic syndromes. Please check your email for instructions on resetting your password. Beerkens et al57 described the first documented case of SCD patient who developed ACS in the setting of COVID‐19. Among 178 persons with SCD in the United States who were reported to an SCD–coronavirus disease case registry, 122 (69%) were hospitalized and 13 (7%) died. If you continue to use this site we will assume that you are happy with it. Hospital care teams are offering most patients telephone or video consultations during the COVID-19 outbreak. This includes eating a varied diet which should include plenty of fresh fruit and vegetable. Mayowa Osundiji, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, 555 University Avenue, University of Toronto, Toronto ON M5G1X8, Canada. If you have sickle cell trait please follow the guidance given to the general public. Sickle cell trait affects approximately 300 million people globally.45 Owing to its protective effects against severe malaria, sickle cell trait confers an evolutionary survival advantage.46 The highest prevalence of sickle cell trait is in Africa and among people of African descent across the world.18, 47 In the United States, national estimates of the sickle cell trait prevalence from Newborn Screening data suggest about 1.5% with about 8% prevalence among African Americans, almost 3 million individuals.48 About 1%‐3% of the European population carries a gene mutation for hemoglobinopathy, particularly sickle cell trait.49-52 Approximately 5% of the world carry a significant hemoglobin gene variant.52 A recent global meta‐estimate of birth prevalence of SCD was approximately 112 per 100 000 live births with about 10 folds higher birth prevalence in Africa, 1125 per 100 000.18, 47, Being the heterozygous state, red blood cells in sickle cell trait have one copy of normal adult hemoglobin (Hb) denoted as HbA and one copy of mutant Hb (HbS) resulting in Hb genotype of HbAS.53 HbS results from a missense mutation causing amino acid substitution whereby valine replaces glutamic acid in the 6th codon of the β chain.54, 55 The presence of HbA attenuates HbS phenotype, reducing the probability of polymer formation; hence, normal hematological parameters are observed in the majority of individuals with sickle cell trait.54 Nevertheless, cumulative evidence suggests that hypoxia may trigger sickle‐related complications such as splenic infarction, thromboembolism, papillary necrosis, exertional rhabdomyolysis, and death in sickle cell trait.26, 31-40, 43, 44. Taking regular moderate exercise is not only good for physical health but also improves general mood and helps overall mental health. In the future, we expect fewer children and young people will be included on the shielded patient list. If you have any concerns about you or your child’s individual risk please discuss it with your specialist team. This may facilitate prompt recognition of at‐risk individuals and the provision of individualized care for instance: anticoagulation,3, 4 oxygen therapy,59 blood transfusion,57, 58 red blood cell exchange transfusion,57, 71 or extracorporeal membrane oxygenation72-74 when necessary. The group reviews guidance issued by NHS England and advises NHS England and patient support groups about specific COVID-19 risks. Sickle cell disease (SCD) disproportionately affects Black or African American persons in the United States and can cause multisystem organ damage and reduced lifespan. If you do not receive an email within 10 minutes, your email address may not be registered, Up to the 23rd September, 263 people had been reported with proven or suspected COVID-19. The carrier frequency for SCD is high among African Americans. There can be confusion as symptoms overlap. Further molecular epidemiological analysis of COVID‐19 disease course and hemoglobin genotype in African Americans are recommended to delineate the potential risks. Hospitals have been re-organised to protect people who come in with non-COVID admissions. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, By continuing to browse this site, you agree to its use of cookies as described in our,, I have read and accept the Wiley Online Library Terms and Conditions of Use, Detection of Covid‐19 in children in Early January 2020 in Wuhan, China, COVID‐19 and its implications for thrombosis and anticoagulation, COVID‐19 associated coagulopathy: The crowning glory of thrombo‐inflammation concept, Characteristics and outcomes of patients hospitalized for COVID‐19 and cardiac disease in Northern Italy, Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019 — United States, February 12–March 28, 2020, Coronavirus disease 2019 in children — United States, February 12–April 2, 2020, COVID‐19 is out of proportion in African Americans.


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