P1435: OUTCOMES OF COVID-19 INFECTION IN INDIVIDUALS WITH SICKLE CELL DISEASE OR SICKLE CELL TRAIT: A SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
Topic: 26. Sickle cell disease Background: The COVID-19 pandemic has led to more than 6 million deaths globally and it remains a public health issue. Clinical manifestations vary widely depending on several factors, including pre-existing comorbidities. Sickle cell disease and sickle cell trait are comprised of a group of conditions that affect hemoglobin, and both are the most common variants worldwide. However, the severity of COVID-19 presentation in these patients is still not well understood. Aims: We aimed to compare COVID-19 outcomes between individuals with SCD/SCT and those without SCD/SCT. Methods: On November 14 of 2022, we systematically searched PubMed, Embase, and Cochrane Library for studies of COVID-19 infection in SCD/SCT patients compared with the non-SCD/SCT population. Key exclusion criteria were not original studies and studies lacking the control group. The primary outcome of interest was mortality. Secondary outcomes were hospitalization rate, intensive care unit (ICU) admission and the need for oxygen support (invasive and non-invasive ventilation). We performed an analysis including only studies with outcomes adjusted for confounding factors and fitting all studies. Subgroup analyses were planned for the black population and pediatric versus non-pediatric patients. We also explored sickle-cell disease-related complications and the COVID-19 infection presentation. Review Manager 5.4 was used for comparative statistical analysis and OpenMeta Analyst for proportion meta-analysis. Results: Overall, 933 were screened and 22 met the inclusion criteria. These described 1725 SCD individuals, 2244 SCT individuals, and 725,340 non-SCD/SCT. In the pooled studies that performed adjusted analysis for confounding factors SCD/SCT patients were found to be at increased risk of death (OR 1.72; CI 95% 1.29 to 2.28; p = 0.0002) compared with the control group. Black individuals with SCT also had a higher mortality rate than black individuals without SCT (OR 1.73; 95% CI 1.16 to 2.59; p = 0.007). The hospitalization rate was considerably greater for the SCD/SCT population (OR 7.57; 95% CI 3.46 to 16.59; p < 0.001). Younger patients were more likely admitted to the hospital than adults (p = 0.04). In the whole study population, no significant difference was found between SCD/SCT and non-SCD/SCT in mortality rate (p = 0.08), both in the pediatric and non-pediatric population, ICU admission (p = 0.44) and oxygen requirements (p = 0.49). Regarding SCD-related complications, 27.2% (95% CI 12.9 to 41.5) of patients developed acute chest syndrome following COVID-19 infection. The vaso-occlusive crisis was reported in 24.6% (95% CI 10.4 to 38.9), and blood transfusion was administered in 26% of cases (95% CI 8.4 to 44.7). Common COVID-19 manifestations in the SCD population were fever, pneumonia, and dyspnea occurring in 47.4% (95% CI 27.5 to 67.3 %), 37.8% (95% CI 18.9 to 56.6 %), and 15.2% (95% CI 11.6 to 18.7 %) of individuals, respectively. Summary/Conclusion: Our large systematic review and meta-analysis demonstrated that patients with SCD/SCT had a higher risk of a severe COVID-19 infection and worse outcomes. Further subgroup analyses are planned to better understand risk differences between SCD and SCT. Future studies are needed to better understand the precise mechanisms leading to increased risk in those with sickle cell trait, as this carrier state is usually considered benign. Keywords: Sickle cell, Sickle cell disease, COVID-19, Sickle cell patient
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,012 | 0,002 |
| Bibliométrie | 0,000 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».