Abstract:
SUMMARYCOVID-19 infection has emerged as a comorbidity that can significantly increase morbidity and mortality in sickle cell patients with ACS (acute thoracic/chest syndrome). The aim of our study was to assess COVID-19-related morbidity and mortality in sickle cell patients with ACS. This was a retrospective, descriptive study of patient records followed over a 36-month period from January 2020 to December 2022. The study was conducted at the national blood transfusion center in Dakar. The sex ratio (M/F) was 0.82. The median age was 26 (17-39) years. The most represented age group was between 21 and 30 years. Factors associated with death were: at baseline, SS genotype, presence of comorbidities (asthma, chronic obstructive pulmonary disease, viral hepatitis B, ischemic heart disease), osteonecrosis of the femoral head, and use of NSAIDs (non-steroidal anti-inflammatory drugs) at diagnosis of COVID-19; at the diagnosis of ACS associated with COVID-19, respiratory distress, hypoxia (Sa02 < 92%), creatininemia >18.5 mg/l, CRP >192 mg/l, lymphopenia; the therapeutic modalities associated with death were: transfusion of RBCs (packed red blood cells) and curative anticoagulation. This study shows that patients with comorbidities and/or chronic complications of sickle cell disease can develop severe forms of ACS associated with COVID 19, leading to death. Other factors linked to death, notably diagnostic and therapeutic, were also identified in the course of this study.
摘要:
SummaryCOVID-19感染已成为一种合并症,可显着增加镰状细胞ACS(急性胸/胸综合征)患者的发病率和死亡率。我们研究的目的是评估镰状细胞ACS患者与COVID-19相关的发病率和死亡率。这是一次回顾,在2020年1月至2022年12月的36个月期间,对患者记录进行了描述性研究.这项研究是在达喀尔的国家输血中心进行的。性别比例(M/F)为0.82。中位年龄为26(17-39)岁。最具代表性的年龄组是21至30岁。与死亡相关的因素是:在基线,SS基因型,存在合并症(哮喘,慢性阻塞性肺疾病,病毒性乙型肝炎,缺血性心脏病),股骨头坏死,以及在诊断COVID-19时使用NSAIDs(非甾体类抗炎药);在诊断与COVID-19,呼吸窘迫相关的ACS时,缺氧(Sa02<92%),肌酐血症>18.5毫克/升,CRP>192mg/l,淋巴细胞减少;与死亡相关的治疗方式是:输血红细胞(浓缩红细胞)和治疗性抗凝。这项研究表明,患有镰状细胞病的合并症和/或慢性并发症的患者可以发展为与COVID19相关的严重形式的ACS,从而导致死亡。其他与死亡有关的因素,特别是诊断和治疗,在本研究过程中也发现了。