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Letters to the Editor
health care services for essential treatment. Our survey provides insight into the prevalence of COVID-19 in hemoglobinopathy and rare inherited anemia patients. It is estimated that there are 13,655 patients with SCD in England.7 Based on the age distribution of patients on the NHR, cases reported represent 1.2% of the SCD patient population, comprising 1.8% of adults and 0.3% of chil- dren. The equivalent figures for thalassemia (with 1,564 patients on the NHR) are similar; overall 1.6%, adults 2.3% and children 0.4%. Nationally 35-40% of hemoglo- binopathy patients fall into the pediatric age group. The low incidence of COVID-19 repor-ted in children with hemoglobinopathies is consistent with its characteristic course, which, with the exception of the hyperinflamma- tory syndrome described,8 is generally mild in this age group. This implies shielding may not be necessary for children with sickle cell and thalassemia disorders, other than in defined risk categories such as after hematopoietic stem cell transplantation. This has important implications for schooling and social development.
Two recent reports from France and the USA have described patient characteristics and outcomes of con- firmed COVID-19 in SCD.9,10 In the USA registry hospital- ization, intensive care unit (ICU) admission and case fatal- ity rates were broadly similar to those seen in the UK. A higher rate of ICU admission (20.5%) and lower mortality (2.4%) was found among hospitalized patients in France.
AB
Figure 2. Schematic of the genotype/phenotype, COVID-19 diagnosis, ma- nagement and outcome for patients with hemoglobinopathy or rare inherit- ed anemia reported between April 8 and May 6, 2020. Total population (A), sickle cell disease (B) and thalassemia (C). TDT: transfusion dependent tha- lassemia; NTDT: non-transfusion dependent thalassemia; HbH: hemoglobin H disease. Symbols in yellow denote the PCR status and management of patients as follows: + PCR-positive; – PCR-negative; *: not tested; ?: status of testing unknown; triangle: non-invasive ventilation; inverted triangle: mechanical ventilation. For deaths, each column of symbols corresponds to an individual patient.
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