Sickle Cell Disorders and Severe COVID-19 Outcomes: A Cohort Study

Background: Sickle cell disease is a collection of compound heterozygote hemoglobinopathies, including sickle cell anemia (1). The heterozygote hemoglobinopathies are characterized by erythrocyte deformation with hemolysis; immune and coagulation dysfunction; and chronic complications, including pulmonary hypertension and cardiac failure (1, 2). Sickle cell trait is a carrier status for sickle cell disease. Given the established susceptibility to other viral infections and the ethnic “patterning” of sickle cell disorders, affected persons may have increased risks for severe COVID-19. Evidence about COVID-19 risks in sickle cell disorders mostly derives from studies of hospitalized persons or selective registries (3–5). Robust quantification of risks in sickle cell disorders at a population level may be informative for public health strategies.