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Aldecoa KAT, Arsene C, Krishnamoorthy G, Chng T, Cherry G, Chowdhury N, Clark R, Deeb D, Deptula L, Dietz G, Eto E, Golston V, Lawson L, Mbionwu C, Okponyia O, Orejuela J, Qipo T, Raut S, Goodman J. Risk and Protective Factors for COVID-19 Infection among Pregnant Women with Sickle Cell Trait. Adv Hematol 2024; 2024:1595091. [PMID: 38899005 PMCID: PMC11186680 DOI: 10.1155/2024/1595091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/30/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Pregnant women and individuals with sickle cell trait (SCT) and underlying comorbidities are both independently more vulnerable to severe illness from coronavirus disease 2019 (COVID-19) compared to nonpregnant women and those without SCT. However, our understanding of the specific factors influencing susceptibility to COVID-19 infection among pregnant women with SCT is currently constrained by limited available data. This study aims to determine the risk and protective factors that influence the likelihood of COVID-19 infection in this population. A retrospective analysis was done among 151 women with SCT in the reproductive age group. Multivariable analysis was performed to determine the various factors affecting COVID-19 infection among pregnant women with SCT. The study found that COVID-19-vaccinated pregnant women with SCT had a 90% lower risk of contracting COVID-19 and were 9 times more likely to have a COVID-19 infection if they had a history of pulmonary conditions such as asthma or chronic obstructive pulmonary disease. The present study further emphasizes the importance of the COVID-19 vaccine in preventing infection and safeguarding the health of pregnant women with SCT, particularly those with underlying comorbidities.
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Affiliation(s)
- Kim Abbegail Tan Aldecoa
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Camelia Arsene
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Geetha Krishnamoorthy
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Tiffany Chng
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Garrett Cherry
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Nabila Chowdhury
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Ryan Clark
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Dana Deeb
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Lisa Deptula
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Grey Dietz
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Ewomamobuho Eto
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Victoria Golston
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Landon Lawson
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Chioma Mbionwu
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Obiefuna Okponyia
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Detroit Wayne County Authority Health, Detroit, MI, USA
| | - Jennifer Orejuela
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Thomaidha Qipo
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Ross University School of Medicine, Bridgetown, Barbados
| | - Sumit Raut
- Department of Internal Medicine, Trinity Health Oakland, Pontiac, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Judie Goodman
- Department of Hematology and Oncology, Trinity Health Oakland, Pontiac, MI, USA
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Swirsky ES, Boyd AD, Gu C, Burke LA, Doorenbos AZ, Ezenwa MO, Knisely MR, Leigh JW, Li H, Mandernach MW, Molokie RE, Patil CL, Steffen AD, Shah N, deMartelly VA, Staman KL, Schlaeger JM. Monitoring and responding to signals of suicidal ideation in pragmatic clinical trials: Lessons from the GRACE trial for Chronic Sickle Cell Disease Pain. Contemp Clin Trials Commun 2023; 36:101218. [PMID: 37842321 PMCID: PMC10569945 DOI: 10.1016/j.conctc.2023.101218] [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: 07/10/2023] [Revised: 09/11/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023] Open
Abstract
Sickle cell disease (SCD) is a hemoglobin disorder and the most common genetic disorder that affects 100,000 Americans and millions worldwide. Adults living with SCD have pain so severe that it often requires opioids to keep it in control. Depression is a major global public health concern associated with an increased risk in chronic medical disorders, including in adults living with sickle cell disease (SCD). A strong relationship exists between suicidal ideation, suicide attempts, and depression. Researchers enrolling adults living with SCD in pragmatic clinical trials are obligated to design their methods to deliberately monitor and respond to symptoms related to depression and suicidal ideation. This will offer increased protection for their participants and help clinical investigators meet their fiduciary duties. This article presents a review of this sociotechnical milieu that highlights, analyzes, and offers recommendations to address ethical considerations in the development of protocols, procedures, and monitoring activities related to suicidality in depressed patients in a pragmatic clinical trial.
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Affiliation(s)
| | | | - Carol Gu
- University of Illinois Chicago, Chicago, IL, USA
| | | | | | | | | | | | - Hongjin Li
- University of Illinois Chicago, Chicago, IL, USA
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Colombatti R, Hegemann I, Medici M, Birkegård C. Systematic Literature Review Shows Gaps in Data on Global Prevalence and Birth Prevalence of Sickle Cell Disease and Sickle Cell Trait: Call for Action to Scale Up and Harmonize Data Collection. J Clin Med 2023; 12:5538. [PMID: 37685604 PMCID: PMC10488271 DOI: 10.3390/jcm12175538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Sickle cell disease (SCD) is an inherited monogenic disorder with high prevalence throughout sub-Saharan Africa, the Mediterranean basin, the Middle East, and India. Sources of SCD epidemiology remain scarce and fragmented. A systematic literature review (SLR) to identify peer-reviewed studies on SCD epidemiology was performed, with a search of bibliographic databases and key conference proceedings from 1 January 2010 to 25 March 2022 (congress abstracts after 2018). The SLR followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Meta-analyses, using a binomial normal random-effects model, were performed to estimate global and regional prevalence and birth prevalence. Of 1770 journal articles and 468 abstracts screened, 115 publications met the inclusion criteria. Prevalence was highest in Africa (~800/100,000), followed by the Middle East (~200/100,000) and India (~100/100,000), in contrast to ~30/100,000 in Europe. Birth prevalence was highest in Africa (~1000/100,000) and lowest in North America (~50/100,000) and Europe (~30/100,000). This SLR confirmed that sub-Saharan and North-East Africa, India, the Middle East, and the Caribbean islands are global SCD hotspots. Publications including mortality data were sparse, and no conclusions could be drawn about mortality. The identified data were limited due to gaps in the published literature for large parts of the world population; the inconsistent reporting of SCD genotypes, diagnostic criteria, and settings; and a sparsity of peer-reviewed publications from countries with assumed high prevalence. This SLR demonstrated a lack of systematic knowledge and a need to provide uniform data collection on SCD prevalence and mortality.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Child and Maternal Health, Azienda Ospedaliera, University of Padova, 35122 Padua, Italy
| | | | - Morten Medici
- Novo Nordisk A/S, 2860 Søborg, Denmark; (M.M.); (C.B.)
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Bojja S, Javed N, Allena N, Bojja S, Khaja M. Rare Cause of Acute Loss of Vision in a Patient With Sickle Cell Trait. Cureus 2023; 15:e42535. [PMID: 37637596 PMCID: PMC10460114 DOI: 10.7759/cureus.42535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Sickle cell disease (SCD) is a prevalent inherited blood disorder with various ocular manifestations, including sickle cell retinopathy (SCR), characterized by retinal microcirculation impairment and ischemic complications. We present the case of a 21-year-old male with sickle cell trait who experienced a sudden, painless loss of vision in his left eye. Ophthalmologic examination revealed vitreous hemorrhage and neovascularization, indicating SCR. Initial treatment with hydroxyurea and exchange transfusions led to partial improvement. However, due to persistent vitreous hemorrhage, the patient underwent a vitrectomy. The sickle cell trait affects a large global population, and its retinopathy is a rare but severe complication. The pathogenesis and risk factors for SCR are similar to those for SCD. The diagnosis of SCR is established through fundoscopic examination and graded based on Goldberg's classification. Management involves a multidisciplinary approach targeting systemic illness and visual defects, including hydroxyurea, photocoagulation, anti-vascular endothelial growth factors, and vitrectomy. Awareness, early diagnosis, and timely intervention are essential to preventing vision-threatening complications in sickle cell trait patients with SCR.
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Affiliation(s)
- Srikaran Bojja
- Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Nismat Javed
- Internal Medicine, BronxCare Health System, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Nishant Allena
- Pulmonology, BronxCare Health System, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Shreya Bojja
- Medicine, Mallareddy Institute Of Medical Sciences, Hyderabad , IND
| | - Misbahuddin Khaja
- Internal Medicine/Pulmonary Critical Care, BronxCare Health System, Icahn School of Medicine at Mount Sinai, New York City, USA
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Yaokreh JB, Thomas HA, Ekobo PC, Kouamé GSY, Kouamé BD, Ouattara O. Haematogenous osteoarticular infections in paediatric sickle cell trait patients: A reality in a tertiary centre in West Africa. Afr J Paediatr Surg 2021; 18:62-66. [PMID: 33595545 PMCID: PMC8109757 DOI: 10.4103/ajps.ajps_114_20] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sickle cell trait (SCT) affects at least 5.2% of the world population, and it is considered asymptomatic by medical practitioners. There is a paucity of data regarding SCT paediatric patients and haematogenous osteoarticular infections (HOAIs). In our practice, some children with SCT presented HOAIs. This study aims to describe the pattern of HOAIs in children with SCT admitted in our unit. MATERIALS AND METHODS A single-centre retrospective study of medical records of SCT paediatric patients treated for HOAIs between January 2012 and June 2019 was performed. The data extracted were epidemiologic (gender, age at diagnosis, history of haemoglobinopathy and ethnic group), diagnostic (time to diagnosis, type of infection and fraction of haemoglobin S [HbS] at standard electrophoresis of Hb), germs and complications. RESULTS Among 149 patients with haemoglobinopathy treated for HOAIs, 52 have SCT. The prevalence of SCT patients was 34.9%. Thirty-nine (n = 39) records were retained for the study. The average age at diagnosis was 7.18 ± 4.59 years (7 months-15 years). The Malinké ethnic group was found in 22 (56.4%) cases. The mean HbS fraction was 37.2% ± 4.3% (30%-46%). Septic arthritis and osteoarthritis involved the hip in 11 cases, the shoulder in 4 and the knee in 2. Osteomyelitis was acute in 5 cases (11.1%) and chronic in 16 (35.5%). None of the patients has multifocal involvements. Bacterial identification was positive in 17 cases (37.8%). Staphylococcus aureus was involved in 9 cases (52.9%), and in one case, it was Mycobacterium tuberculosis. This patient has abscess of the psoas. No patient was infected by human immunodeficiency virus. The sequelae were joint destruction (n = 2), epiphysiodesis (n = 5) and retractile scars (n = 2). CONCLUSION Relatively infrequent in our daily practice, SCT patients present with HOAIs. These infections had characteristics that are not very different from the series of the literature.
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Affiliation(s)
| | | | | | | | | | - Ossénou Ouattara
- Department of Pediatric Surgery, CHU Yopougon, Abidjan, Côte d'Ivoire
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Jaber RZ, Hassan MK, Al-Salait SK. Microcytosis in children and adolescents with the sickle cell trait in Basra, Iraq. Blood Res 2019; 54:38-44. [PMID: 30956962 PMCID: PMC6439302 DOI: 10.5045/br.2019.54.1.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/29/2018] [Accepted: 10/01/2018] [Indexed: 11/17/2022] Open
Abstract
Background Microcytic anemia, the most common form of anemia in children and adolescents, is a heterogeneous group of diseases that is acquired or inherited. We assessed the frequency and causes of microcytosis in children and adolescents with the sickle cell trait (SCT). Methods This descriptive study included 95 subjects (49 males and 46 females) with SCT who attended Basra Center for Hereditary Blood Diseases for evaluation. Investigations included complete blood count, high performance liquid chromatography, capillary electrophoresis, and measurement of serum ferritin and transferrin levels. Results SCT subjects had a low hemoglobin (Hb) concentration (9.79±1.75 g/dL), low mean corpuscular volume (MCV, 67.43±9.22), low mean corpuscular Hb (21.15±3.64), and a normal red cell distribution width (RDW, 14.00±2.30). Among 95 SCT subjects, 81 (85.26%) had microcytosis, 12 (12.63%) had normal MCV, and 2 (2.11%) exhibited macrocytosis. Sixty-three (77.78%) SCT subjects with microcytosis were iron deficient, and 18 (22.22%) had normal iron levels. The mean serum ferritin and HbA2 levels were significantly lower, while the RDW, sickle Hb, and serum transferrin levels were significantly higher in patients with microcytosis and iron deficiency compared to non-iron deficient subjects (P<0.05). Correlation coefficients did not reveal a significant association between the MCV and iron status of SCT subjects (P>0.05). Conclusion Despite the frequent occurrence of iron deficiency in SCT subjects, co-inheritance of alpha-thalassemia seemed to be the cause of low MCV in non-iron deficient individuals with microcytosis. Genetic analysis is required to understand the genetic basis of this phenomenon.
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Affiliation(s)
| | - Meàad Kadhum Hassan
- Center for Hereditary Blood Diseases, Basrah Heath Directorate, Basrah, Iraq.,Department of Pediatrics, College of Medicine, University of Basrah, Basrah, Iraq
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