Introduction:
Sickle Cell disease (SCD) is one of the most common hemoglobinopathies,
it is due to mutation on the beta chain hemoglobin that causes deformity
in red blood cells (RBCs) shape. The sickle shape of RBCs affects their
function leading to hypoxia and sickle cell crisis including hemolysis
when triggers like infections happen[1].
With the widely spread of Coronavirus infection, special population
needs close monitoring as the exact clinical course and prognosis is not
well known yet[2]. It was suggested that patients with SCD might
present with vaso-occlusive crisis (VOCs) or acute chest syndrome (ACS)
as first presentation of COVID-19 infection[3]. The overlap between
ACS and COVID-19 pneumonia made this an interesting area for
research[4]. However, hemolytic crisis was not very common among
previously reported cases[5].
Management plan for patients with SCD presenting with COVID-19 infection
is not final yet[6]. However, following the recognized guideline for
painful crisis, ACS and hemolysis treatment is essential. Previous
studies showed the remarkable favorable impact of RBCs exchange in the
course of COVID-19 infection among patients with
hemoglobinopathies[7]. We believe it might prevent deterioration if
offered earlier in the course of the disease. Treatment with hydroxyurea
might or might not affect the susceptibility of COVID-19
infection[6]. Admission to the hospital is also required even if the
cases are asymptomatic or mild because acute complications seems to
happen after few days of infection.
Here we report a case of 48-year-old SCD patient compliant with HU who
underwent post travel screening for COVID-19 infection and tested
positive, admission and close monitoring were offered, he developed
painful crisis and sever hemolysis after few days thus needed ICU
admission and improved after RBCs exchange.