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Li XY, Kong XM, Yang CH, Cheng ZF, Lv JJ, Guo H, Liu XH. Global, regional, and national burden of ischemic stroke, 1990-2021: an analysis of data from the global burden of disease study 2021. EClinicalMedicine 2024; 75:102758. [PMID: 39157811 PMCID: PMC11327951 DOI: 10.1016/j.eclinm.2024.102758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/12/2024] [Accepted: 07/12/2024] [Indexed: 08/20/2024] Open
Abstract
Background Ischemic stroke remains a major contributor to global mortality and morbidity. This study aims to provide an updated assessment of rates in ischemic stroke prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2021, specifically focusing on including prevalence investigation alongside other measures. The analysis is stratified by sex, age, and socio-demographic index (SDI) at global, regional, and national levels. Methods Data for this study was obtained from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). To quantify temporal patterns and assess trends in age-standardized rates of ischemic stroke prevalence (ASPR), incidence (ASIR), mortality (ASDR), and DALYs, estimated annual percentage changes (EAPCs) were computed over the study period. The analyses were disaggregated by gender, 20 age categories, 21 GBD regions, 204 nations/territories, and 5 SDI quintiles. R statistical package V 4.4.2 was performed for statistical analyses and plot illustrations. Findings In 2021, the global burden of ischemic stroke remained substantial, with a total of 69,944,884.8 cases with an ASPR of 819.5 cases per 100,000 individuals (95% UI: 760.3-878.7). The ASIR was 92.4 per 100,000 people (95% UI: 79.8-105.8), while the ASDR was 44.2 per 100,000 persons (95% UI: 39.3-47.8). Additionally, the age-standardized DALY rate was 837.4 per 100,000 individuals (95% UI: 763.7-905). Regionally, areas with high-middle SDI exhibited the greatest ASPR, ASIR, ASDR, and age-standardized DALY rates, whereas high SDI regions had the lowest rates. Geospatially, Southern Sub-Saharan Africa had the highest ASPR, while Eastern Europe showed the highest ASIR. The greatest ASDR and age-standardized DALY rates were observed in Eastern Europe, Central Asia, as well as North Africa, and the Middle East. Among countries, Ghana had the highest ASPR, and North Macedonia had both the highest ASIR and ASDR. Furthermore, North Macedonia also exhibited the highest age-standardized DALY rate. Interpretation Regions with high-middle and middle SDI continued to experience elevated ASPR, ASIR, ASDR and age-standardized DALY rates. The highest ischemic stroke burden was observed in Southern Sub-Saharan Africa, Central Asia, Eastern Europe, and the Middle East. Funding None.
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Affiliation(s)
- Xin-yu Li
- Department of Neurology, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiang-meng Kong
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng-hao Yang
- Department of Neurology, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Vascular Surgery, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhi-feng Cheng
- Department of Vascular Surgery, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jia-jie Lv
- Department of Vascular Surgery, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Neurosurgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, Shanghai, PR China
| | - Hong Guo
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao-hong Liu
- Department of Neurology, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, China
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Mauermann ML, Southerland AM. Hematologic Disorders and the Nervous System. Continuum (Minneap Minn) 2023; 29:826-847. [PMID: 37341332 DOI: 10.1212/con.0000000000001238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVE This article discusses the epidemiology, diagnosis, treatment, and prevention of neurologic complications of red blood cell, platelet, and plasma cell disorders. LATEST DEVELOPMENTS Cerebrovascular complications can occur in patients with blood cell and platelet disorders. Treatment strategies to prevent stroke are available for patients with sickle cell disease, polycythemia vera, and essential thrombocythemia. A diagnosis of thrombotic thrombocytopenic purpura should be considered in patients with neurologic symptoms, hemolytic anemia, thrombocytopenia, mild renal insufficiency, and fever. Plasma cell disorders can be associated with peripheral neuropathy, and classification of the monoclonal protein type and neuropathy aid in diagnosis. Patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes) syndrome can present with arterial and venous neurologic events. ESSENTIAL POINTS This article discusses the neurologic complications of blood cell disorders and the most recent advances in prevention and treatment.
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Wang Y, Guilliams KP, Fields ME, Fellah S, Binkley MM, Reis M, Vo KD, Chen Y, Ying C, Blinder M, King AA, Hulbert ML, An H, Lee JM, Ford AL. Silent Infarcts, White Matter Integrity, and Oxygen Metabolic Stress in Young Adults With and Without Sickle Cell Trait. Stroke 2022; 53:2887-2895. [PMID: 35545940 PMCID: PMC9398918 DOI: 10.1161/strokeaha.121.036567] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with sickle cell anemia have heightened risk of stroke and cognitive dysfunction. Given its high prevalence globally, whether sickle cell trait (SCT) is a risk factor for neurological injury has been of interest; however, data have been limited. We hypothesized that young, healthy adults with SCT would show normal cerebrovascular structure and hemodynamic function. METHODS As a case-control study, young adults with (N=25, cases) and without SCT (N=24, controls) underwent brain magnetic resonance imaging to quantify brain volume, microstructural integrity (fractional anisotropy), silent cerebral infarcts (SCI), intracranial stenosis, and aneurysms. Pseudocontinuous arterial spin labeling and asymmetric spin echo sequences measured cerebral blood flow and oxygen extraction fraction, respectively, from which cerebral metabolic oxygen demand was calculated. Imaging metrics were compared between SCT cases and controls. SCI volume was correlated with baseline characteristics. RESULTS Compared with controls, adults with SCT demonstrated similar normalized brain volumes (SCT 0.80 versus control 0.81, P=0.41), white matter fractional anisotropy (SCT 0.41 versus control 0.43, P=0.37), cerebral blood flow (SCT 62.04 versus control, 61.16 mL/min/100 g, P=0.67), oxygen extraction fraction (SCT 0.27 versus control 0.27, P=0.31), and cerebral metabolic oxygen demand (SCT 2.71 versus control 2.70 mL/min/100 g, P=0.96). One per cohort had an intracranial aneurysm. None had intracranial stenosis. The SCT cases and controls showed similar prevalence and volume of SCIs; however, in the subset of participants with SCIs, the SCT cases had greater SCI volume versus controls (0.29 versus 0.07 mL, P=0.008). Of baseline characteristics, creatinine was mildly elevated in the SCT cohort (0.9 versus 0.8 mg/dL, P=0.053) and correlated with SCI volume (ρ=0.49, P=0.032). In the SCT cohort, SCI distribution was similar to that of young adults with sickle cell anemia. CONCLUSIONS Adults with SCT showed normal cerebrovascular structure and hemodynamic function. These findings suggest that healthy individuals with SCT are unlikely to be at increased risk for early or accelerated ischemic brain injury.
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Affiliation(s)
- Yan Wang
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Kristin P Guilliams
- Division of Pediatric Neurology, Washington University School of Medicine, St. Louis, MO
| | - Melanie E Fields
- Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis, MO
| | - Slim Fellah
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Michael M Binkley
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Martin Reis
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Katie D. Vo
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Yasheng Chen
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Chunwei Ying
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Morey Blinder
- Program in Occupational Therapy and Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine and St. Louis Children’s Hospital, St. Louis, MO
| | - Allison A. King
- Department of Medicine, Division of hematology/oncology, Washington University School of Medicine, St. Louis, MO
| | - Monica L. Hulbert
- Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis, MO
| | - Hongyu An
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Andria L. Ford
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
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Caughey MC, Derebail VK, Carden MA, Novelli EM, Lutsey PL, Key NS, Kshirsagar AV, Heiss G. Prevalence and outcomes of dehydration in adults with sickle cell trait: the Atherosclerosis Risk in Communities (ARIC) study. Br J Haematol 2022; 198:397-400. [PMID: 35510344 DOI: 10.1111/bjh.18221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Melissa C Caughey
- Joint Department of Biomedical Engineering, University of North Carolina and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Vimal K Derebail
- Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Enrico M Novelli
- Heart, Lung, Blood, and Vascular Medicine Institute and Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nigel S Key
- Division of Hematology and Blood Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abhijit V Kshirsagar
- Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Farrell PM, Langfelder-Schwind E, Farrell MH. Challenging the dogma of the healthy heterozygote: Implications for newborn screening policies and practices. Mol Genet Metab 2021; 134:8-19. [PMID: 34483044 DOI: 10.1016/j.ymgme.2021.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
Heterozygous (carrier) status for an autosomal recessive condition is traditionally considered to lack significance for an individual's health, but this assumption has been challenged by a growing body of evidence. Carriers of several autosomal recessive disorders and some X-linked diseases are potentially at risk for the pathology manifest in homozygotes. This minireview provides an overview of the literature regarding health risks to carriers of two common autosomal recessive conditions on the Recommended Uniform Screening Panel: sickle cell disease [sickle cell trait (SCT)] and cystic fibrosis (CF). We also consider and comment on bioethical and policy implications for newborn blood screening (NBS). Health risks for heterozygotes, while relatively low for individuals, are often influenced by intrinsic (e.g., other genomic variants or co-morbidities) and extrinsic (environmental) factors, which present opportunities for personalized genomic medicine and risk counseling. They create a special challenge, however, for developing screening/follow-up policies and for genetic counseling, particularly after identification and reporting of heterozygote status through NBS. Although more research is needed, this minireview of the SCT and CF literature to date leads us to propose that blanket terms such as "healthy heterozygotes" or "unaffected carriers" should be superseded in communications about NBS results, in favor of a more nuanced paradigm of setting expectations for health outcomes with "genotype-to-risk." In the molecular era of NBS, it remains clear that public health needs to become better prepared for the full range of applied genetics.
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Affiliation(s)
- Philip M Farrell
- Departments of Pediatrics and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Clinical Sciences Center (K4/948), Madison, WI 53792, USA.
| | - Elinor Langfelder-Schwind
- The Cystic Fibrosis Center, Mount Sinai Beth Israel, Department of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, 1st Ave at 16th Street, 8F18, New York, NY 10003, USA.
| | - Michael H Farrell
- Departments of Internal Medicine and Pediatrics, University of Minnesota Medical School, Division of General Internal Medicine (MMC 741), 420 Delaware St SE, Minneapolis, MN 55455, USA.
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Isokpehi RD, Johnson CP, Tucker AN, Gautam A, Brooks TJ, Johnson MO, Cozart T, Wathington DJ. Integrating Datasets on Public Health and Clinical Aspects of Sickle Cell Disease for Effective Community-Based Research and Practice. Diseases 2020; 8:E39. [PMID: 33114600 PMCID: PMC7709136 DOI: 10.3390/diseases8040039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/11/2020] [Accepted: 10/20/2020] [Indexed: 11/22/2022] Open
Abstract
Sickle cell disease (SCD) is a genetic disease that has multiple aspects including public health and clinical aspects. The goals of the research study were to (1) understand the public health aspects of sickle cell disease, and (2) understand the overlap between public health aspects and clinical aspects that can inform research and practice beneficial to stakeholders in sickle cell disease management. The approach involved the construction of datasets from textual data sources produced by experts on sickle cell disease including from landmark publications published in 2020 on sickle cell disease in the United States. The interactive analytics of the integrated datasets that we produced identified that community-based approaches are common to both public health and clinical aspects of sickle cell disease. An interactive visualization that we produced can aid the understanding of the alignment of governmental organizations to recommendations for addressing sickle cell disease in the United States. From a global perspective, the interactive analytics of the integrated datasets can support the knowledge transfer stage of the SICKLE recommendations (Skills transfer, Increasing self-efficacy, Coordination, Knowledge transfer, Linking to adult services, and Evaluating readiness) for effective pediatric to adult transition care for patients with sickle cell disease. Considering the increased digital transformations resulting from the COVID-19 pandemic, the constructed datasets from expert recommendations can be integrated within remote digital platforms that expand access to care for individuals living with sickle cell disease. Finally, the interactive analytics of integrated expert recommendations on sickle cell disease management can support individual and team expertise for effective community-based research and practice.
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Affiliation(s)
- Raphael D. Isokpehi
- Center for Trans-Disciplinary Data Analytics, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (A.N.T.); (A.G.); (T.J.B.)
| | - Chomel P. Johnson
- Master of Public Health Program, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (C.P.J.); (M.O.J.); (T.C.); (D.J.W.)
- Health Equity Internship Program, Association of State Public Health Nutritionists, P.O. Box 37094, Tucson, AZ 85740, USA
| | - Ashley N. Tucker
- Center for Trans-Disciplinary Data Analytics, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (A.N.T.); (A.G.); (T.J.B.)
| | - Aakriti Gautam
- Center for Trans-Disciplinary Data Analytics, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (A.N.T.); (A.G.); (T.J.B.)
| | - Taylor J. Brooks
- Center for Trans-Disciplinary Data Analytics, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (A.N.T.); (A.G.); (T.J.B.)
| | - Matilda O. Johnson
- Master of Public Health Program, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (C.P.J.); (M.O.J.); (T.C.); (D.J.W.)
- Health Equity Internship Program, Association of State Public Health Nutritionists, P.O. Box 37094, Tucson, AZ 85740, USA
| | - Thometta Cozart
- Master of Public Health Program, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (C.P.J.); (M.O.J.); (T.C.); (D.J.W.)
- Health Equity Internship Program, Association of State Public Health Nutritionists, P.O. Box 37094, Tucson, AZ 85740, USA
- Department of Public Health and Health Equity, Bethune-Cookman University, Daytona Beach, FL 32114, USA
| | - Deanna J. Wathington
- Master of Public Health Program, Bethune-Cookman University, Daytona Beach, FL 32114, USA; (C.P.J.); (M.O.J.); (T.C.); (D.J.W.)
- Department of Public Health and Health Equity, Bethune-Cookman University, Daytona Beach, FL 32114, USA
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Zhang RV, Ryan KA, Lopez H, Wozniak MA, Phipps MS, Cronin CA, Cole JW, Dutta TM, Mehndiratta P, Motta M, Merino JG, Kittner SJ. Sickle Cell Trait and Risk of Ischemic Stroke in Young Adults. Stroke 2020; 51:e238-e241. [PMID: 32781942 DOI: 10.1161/strokeaha.119.028404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Approximately 8% of Blacks have sickle cell trait (SCT), and there are conflicting reports from recent cohort studies on the association of SCT with ischemic stroke (IS). Most prior studies focused on older populations, with few data available in young adults. METHODS A population-based case-control study of early-onset IS was conducted in the Baltimore-Washington region between 1992 and 2007. From this study, 342 Black IS cases, ages 15 to 49, and 333 controls without IS were used to examine the association between SCT and IS. Each participant's SCT status was established by genotyping and imputation. For analysis, χ2 tests and logistic regression models were performed with adjustment for potential confounding variables. RESULTS Participants with SCT (n=55) did not differ from those without SCT (n=620) in prevalence of hypertension, previous myocardial infarction, diabetes mellitus, and current smoking status. Stroke cases had increased prevalence in these risk factors compared with controls. We did not find an association between SCT and early-onset IS in our overall population (odds ratio=0.9 [95% CI, 0.5-1.7]) or stratified by sex in males (odds ratio=1.26 [95% CI, 0.56-2.80]) and females (odds ratio=0.67 [95% CI, 0.28-1.69]). CONCLUSIONS Our data did not find evidence of increased risk of early-onset stroke with SCT.
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Affiliation(s)
- Rebecca V Zhang
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore
| | - Kathleen A Ryan
- Department of Medicine (K.A.R.), University of Maryland School of Medicine, Baltimore.,VA Maryland Health Care System, Baltimore (K.A.R., H.L., M.A.W., M.S.P., C.A.C., J.W.C., S.J.K.)
| | - Haley Lopez
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore.,VA Maryland Health Care System, Baltimore (K.A.R., H.L., M.A.W., M.S.P., C.A.C., J.W.C., S.J.K.)
| | - Marcella A Wozniak
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore.,VA Maryland Health Care System, Baltimore (K.A.R., H.L., M.A.W., M.S.P., C.A.C., J.W.C., S.J.K.)
| | - Michael S Phipps
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore.,VA Maryland Health Care System, Baltimore (K.A.R., H.L., M.A.W., M.S.P., C.A.C., J.W.C., S.J.K.)
| | - Carolyn A Cronin
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore.,VA Maryland Health Care System, Baltimore (K.A.R., H.L., M.A.W., M.S.P., C.A.C., J.W.C., S.J.K.)
| | - John W Cole
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore.,VA Maryland Health Care System, Baltimore (K.A.R., H.L., M.A.W., M.S.P., C.A.C., J.W.C., S.J.K.)
| | - Tara M Dutta
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore
| | - Prachi Mehndiratta
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore
| | - Melissa Motta
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore
| | - José G Merino
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore
| | - Steven J Kittner
- Department of Neurology (R.V.Z., H.L., M.A.W., M.S.P., C.A.C., J.W.C., T.M.D., P.M., M.M., J.G.M., S.J.K.), University of Maryland School of Medicine, Baltimore.,VA Maryland Health Care System, Baltimore (K.A.R., H.L., M.A.W., M.S.P., C.A.C., J.W.C., S.J.K.)
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Kehinde TA, Osundiji MA. Sickle cell trait and the potential risk of severe coronavirus disease 2019-A mini-review. Eur J Haematol 2020; 105:519-523. [PMID: 32589774 PMCID: PMC7361772 DOI: 10.1111/ejh.13478] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/14/2022]
Abstract
Coronavirus Disease 2019 (COVID‐19) pandemic is a rapidly evolving public health problem. The severity of COVID‐19 cases reported hitherto has varied greatly from asymptomatic to severe pneumonia and thromboembolism with subsequent mortality. An improved understanding of risk factors for adverse clinical outcomes may shed some light on novel personalized approaches to optimize clinical care in vulnerable populations. Emerging trends in the United States suggest possibly higher mortality rates of COVID‐19 among African Americans, although detailed epidemiological study data is pending. Sickle cell disease (SCD) disproportionately affects Black/African Americans in the United States as well as forebearers from sub‐Saharan Africa, the Western Hemisphere (South America, the Caribbean, and Central America), and some Mediterranean countries. The carrier frequency for SCD is high among African Americans. This article underscores the putative risks that may be associated with COVID‐19 pneumonia in sickle cell trait as well as potential opportunities for individualized medical care in the burgeoning era of personalized medicine.
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Affiliation(s)
| | - Mayowa Azeez Osundiji
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Neuberg D. Dissecting the web of ischemic stroke, sickle cell trait, and chronic kidney disease. Am J Hematol 2019; 94:1302. [PMID: 31591745 DOI: 10.1002/ajh.25649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Donna Neuberg
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
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