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.