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Prevalence of COVID-19 in Sickle Cell Patients in Abidjan (Ivory Coast)

Kakou Danho Bassimbié J, Atiméré Y N, Koné D, Diallo M, AKroman M, Tolo-Diebikilé A.

Abstract

In 2019, the world faced a severe COVID-19 pandemic. Côte d'Ivoire was among the fifteen most affected countries worldwide [1], with a high prevalence of sickle cell disease, ranging from 12% to 14%. It therefore seemed crucial to study the impact of COVID-19 on sickle cell patients and their interrelationships.

The objective of this study was to determine the epidemiological, clinical, and biological profile of sickle cell patients who tested positive for COVID-19.

This was a prospective, descriptive, and analytical study conducted over a period of three months, from February to May 2022, involving 200 sickle cell patients randomly selected from three sites1 in Abidjan, in Cote d’Ivoire. A nasopharyngeal swab was taken from each patient after obtaining their consent and then sent to the Pasteur Institute of Abidjan for antigen testing (SARS-CoV-2). Data were collected on questionnaires, entered into Microsoft Excel, processed using SPSS software, and statistically analyzed (Chi-square, Student's t-test).

The results showed a COVID-19 prevalence of 13%; 69% of patients had the SS genotype with an average age of 27.2 years, close to the 27.4 years reported by Arlet [2]. The majority of patients were asymptomatic (98%) and had blood type O Rh positive. Patients presented with anemia (mean Hb level of 8 g/dl), moderate neutrophilic leukocytosis, and lymphopenia. Chronic anemia is characteristic of Major Sickle cell Syndromes; however, the neutrophilic leukocytosis and lymphopenia contrasted with the near absence of inflammatory signs, with only 6, 95% testing positive for CRP.

There was no statistically significant relationship between the SS genotype and COVID-19 (P = 0.5444). The same was true for age (P = 0.0998), sex (P = 0.1015), hemoglobin level (p = 0.09), and blood type (P = 0.6963).

Despite the susceptibility to infections in sickle cell patients, the SARS-CoV-2 coronavirus did not appear to have an impact on the subjects in our study. This could be explained by the small size of our sample. However, SARS-CoV-2 infection can manifest solely as a vaso-occlusive crisis, without any associated infectious or respiratory symptoms [3].

Conclusion: The low vaccination rate (1%) underscores the need for intensified awareness campaigns to encourage sickle cell patients to get vaccinated against COVID-19. It is imperative to make COVID-19 screening systematic for sickle cell patients in Côte d'Ivoire.