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      Sickle cell disease and COVID‐19: Susceptibility and severity

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          Abstract

          We surveyed published papers and an international sickle cell disease (SCD) registry to detect susceptibility and clinical course of coronavirus disease 2019 (COVID‐19) in SCD patients. COVID‐19 presentation was mild in children and moderate in many SCD adults. Regarding increased comorbidities with age, it seems severe COVID‐19 to be more common in older SCD patients. Although the overall outcome of COVID‐19 was favorable in SCD children, a high rate of pediatric intensive care unit admission should be considered in managing these patients. To explain COVID‐19 outcome in SCD patients, the possible benefits of hydroxyurea therapy could be considered. The obtained results should be interpreted, considering low cases from sub‐Saharan people, younger age of SCD patients compared to general population, a bias toward registry of the more severe form of disease, the effect of pre‐existing comorbidities with multisystem organ damage, and the role of health socio‐economic determinants.

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          Most cited references50

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          Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units

          The recent and ongoing coronavirus disease 2019 (COVID-19) pandemic has taken an unprecedented toll on adults critically ill with COVID-19 infection. While there is evidence that the burden of COVID-19 infection in hospitalized children is lesser than in their adult counterparts, to date, there are only limited reports describing COVID-19 in pediatric intensive care units (PICUs).
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            Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series

            Abstract Objective To characterize patients with coronavirus disease 2019 (covid-19) in a large New York City medical center and describe their clinical course across the emergency department, hospital wards, and intensive care units. Design Retrospective manual medical record review. Setting NewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center in New York City. Participants The first 1000 consecutive patients with a positive result on the reverse transcriptase polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented to the emergency department or were admitted to hospital between 1 March and 5 April 2020. Patient data were manually abstracted from electronic medical records. Main outcome measures Characterization of patients, including demographics, presenting symptoms, comorbidities on presentation, hospital course, time to intubation, complications, mortality, and disposition. Results Of the first 1000 patients, 150 presented to the emergency department, 614 were admitted to hospital (not intensive care units), and 236 were admitted or transferred to intensive care units. The most common presenting symptoms were cough (732/1000), fever (728/1000), and dyspnea (631/1000). Patients in hospital, particularly those treated in intensive care units, often had baseline comorbidities including hypertension, diabetes, and obesity. Patients admitted to intensive care units were older, predominantly male (158/236, 66.9%), and had long lengths of stay (median 23 days, interquartile range 12-32 days); 78.0% (184/236) developed acute kidney injury and 35.2% (83/236) needed dialysis. Only 4.4% (6/136) of patients who required mechanical ventilation were first intubated more than 14 days after symptom onset. Time to intubation from symptom onset had a bimodal distribution, with modes at three to four days, and at nine days. As of 30 April, 90 patients remained in hospital and 211 had died in hospital. Conclusions Patients admitted to hospital with covid-19 at this medical center faced major morbidity and mortality, with high rates of acute kidney injury and inpatient dialysis, prolonged intubations, and a bimodal distribution of time to intubation from symptom onset.
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              COVID-19 in 7780 pediatric patients: A systematic review

              Background Studies summarizing the clinical picture of COVID-19 in children are lacking. This review characterizes clinical symptoms, laboratory, and imaging findings, as well as therapies provided to confirmed pediatric cases of COVID-19. Methods Adhering to PRISMA guidelines, we searched four medical databases (PubMed, LitCovid, Scopus, WHO COVID-19 database) between December 1, 2019 to May 14, 2020 using the keywords “novel coronavirus”, “COVID-19” or “SARS-CoV-2”. We included published or in press peer-reviewed cross-sectional, case series, and case reports providing clinical signs, imaging findings, and/or laboratory results of pediatric patients who were positive for COVID-19. Risk of bias was appraised through the quality assessment tool published by the National Institutes of Health. PROSPERO registration # CRD42020182261. Findings We identified 131 studies across 26 countries comprising 7780 pediatric patients. Although fever (59·1%) and cough (55·9%) were the most frequent symptoms 19·3% of children were asymptomatic. Patchy lesions (21·0%) and ground-glass opacities (32·9%) depicted lung radiograph and computed tomography findings, respectively. Immunocompromised children or those with respiratory/cardiac disease comprised the largest subset of COVID-19 children with underlying medical conditions (152 of 233 individuals). Coinfections were observed in 5.6% of children and abnormal laboratory markers included serum D-dimer, procalcitonin, creatine kinase, and interleukin-6. Seven deaths were reported (0·09%) and 11 children (0·14%) met inclusion for multisystem inflammatory syndrome in children. Interpretation This review provides evidence that children diagnosed with COVID-19 have an overall excellent prognosis. Future longitudinal studies are needed to confirm our findings and better understand which patients are at increased risk for developing severe inflammation and multiorgan failure. Funding Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study.
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                Author and article information

                Contributors
                zrahimi@kums.ac.ir
                Journal
                Pediatr Blood Cancer
                Pediatr Blood Cancer
                10.1002/(ISSN)1545-5017
                PBC
                Pediatric Blood & Cancer
                John Wiley and Sons Inc. (Hoboken )
                1545-5009
                1545-5017
                01 June 2021
                : e29075
                Affiliations
                [ 1 ] Infectious Diseases Research Center Kermanshah University of Medical Sciences Kermanshah Iran
                [ 2 ] Hematology Research Center Shiraz University of Medical Sciences Shiraz Iran
                [ 3 ] Department of Clinical Biochemistry, Medical School Kermanshah University of Medical Sciences Kermanshah Iran
                [ 4 ] Medical Biology Research Center Kermanshah University of Medical Sciences Kermanshah Iran
                Author notes
                [*] [* ] Correspondence

                Zohreh Rahimi, Department of Clinical Biochemistry, Medical Biology Research Center, Medical School, Kermanshah University of Medical Sciences, Daneshgah Ave, Kermanshah, PO Box 67148‐69914, Iran.

                Email: zrahimi@ 123456kums.ac.ir

                Author information
                https://orcid.org/0000-0001-8555-1001
                https://orcid.org/0000-0001-7589-3307
                Article
                PBC29075
                10.1002/pbc.29075
                8209850
                34061431
                91d44c93-ea4e-41f4-bbc3-2a118ae434f8
                © 2021 Wiley Periodicals LLC

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 06 April 2021
                : 26 November 2020
                : 08 April 2021
                Page count
                Figures: 0, Tables: 2, Pages: 9, Words: 5927
                Categories
                Review
                Review
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.2 mode:remove_FC converted:17.06.2021

                Pediatrics
                covid‐19,hbf,hydroxyurea,hypercoagulation,sickle cell disease,splenectomy
                Pediatrics
                covid‐19, hbf, hydroxyurea, hypercoagulation, sickle cell disease, splenectomy

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