Examining resilience of individuals living with sickle cell disease in the COVID-19 pandemic

"Resilience?" perspectives from adults living with sickle cell disease

OBJECTIVES

This study examines and explores the definition of resilience in adults living with sickle cell disease (SCD) in the United States (U.S.).

METHODS

Participants were recruited between 2014 and 2018, from across the U.S. as part of Insights into Microbiome and Environmental Contributions to Sickle Cell Disease and Leg Ulcers Study (INSIGHTS). Inclusion criteria included age of 18+, a diagnosis of SCD, and completion of the Brief Resilience Scale (BRS). Thirty participants were randomly selected, 15 each from the lowest and highest BRS quartile. A semi-structured qualitative interview was administered. All participants identified as Black with an average age of 42.5 (13 F, 17 M).

RESULTS

Three main concepts emerged in response to the question "How do you define resilience?" (a) not giving up (b) how one deals with challenges and (c) moving forward.

CONCLUSION

This study suggests that current definitions of resilience used in validated survey measures do not match how adults living with SCD define resilience. Our results expand the understanding of resilience as a dynamic process, more about the process of "not giving up." These findings suggest that providers may find it productive to facilitate conversations with adults living with SCD around "how" they approach challenges. This study is also the first of its kind to examine resilience in a community living with SCD.

Resilience in patients and family caregivers living with congenital disorders of glycosylation (CDG): a quantitative study using the brief resilience coping scale (BRCS)

BACKGROUND

Patients and family caregivers living with Congenital Disorders of Glycosylation (CDG) experience a heavy burden, which can impact their resiliency and quality of life. The study's purpose was to measure the resilience levels of patients and family caregivers living with CDG using the brief resilience coping scale.

METHODS

We conducted an observational, cross-sectional study with 23 patients and 151 family caregivers living with CDG. Descriptive analyses were performed to characterize patients with CDG and family caregivers' samples. Additionally, we assessed correlations between resilience and specific variables (e.g., age, academic degree, time until diagnosis) and examined resilience differences between groups (e.g., sex, marital status, occupation, professional and social support).

RESULTS

GNE myopathy was the most prevalent CDG among patients, while in family caregivers was PMM2-CDG. Both samples showed medium levels of resilience coping scores. Individuals with GNE myopathy had significantly higher scores of resilience compared to patients with other CDG. Resilience was positively correlated with educational degree in patients with CDG. Family caregivers had marginally significant higher scores of resilience coping if they received any kind of professional support or had contact with other families or people with the same or similar disease, compared with unsupported individuals.

CONCLUSIONS

Despite the inherited difficulties of living with a life-threatening disease like CDG, patients and family caregivers showed medium resilient coping levels. Resilience scores changed significantly considering the CDG genotype, individual's academic degree and professional and social support. These exploratory findings can empower the healthcare system and private institutions by promoting the development of targeted interventions to enhance individuals` coping skills and improve the overall well-being and mental health of the CDG community.

Presentations and outcomes among sickle cell disease patients with COVID-19 at a large southern healthcare system

OBJECTIVES

Compared with the general population, patients with sickle cell disease (SCD) typically have substantially reduced life expectancies. It is unclear whether SCD patients who acquire COVID-19 have higher rates of complications and mortality than the general population. We sought to elucidate COVID-19 presentation and outcomes in patients with SCD.

METHODS

Using retrospective chart review, we evaluated demographic characteristics, presenting symptoms, chest imaging findings, blood transfusion requirements, need for mechanical ventilation or pressor support, medication administration (including remdesivir and dexamethasone), and survival among individuals with SCD hospitalized with COVID-19 from March 2020 to December 2021.

RESULTS

Among 72 SCD patients, increased pain was the most common presenting symptom followed by cough, fever, and dyspnea. Thirty-seven (44%) received simple transfusion and 14 (17%) underwent exchange transfusion. Lung imaging findings suggestive of COVID-19 were observed in 27 (37%) patients; 21 (29%) patients were treated with remdesivir and 26 (35%) received dexamethasone. Three patients (4%) required mechanical ventilation and pressor support; all three died from COVID complications.

CONCLUSIONS

Pain is the most common presenting symptom in SCD patients with COVID-19. We observed a mortality rate higher than that among the general population among patients who required mechanical ventilation and pressor support.