An Outline to Decrease Burden and Minimize Morbidity
March 24, 2020- Sickle cell disease (SCD) affects 100,000 individuals in the United States and millions globally. Individuals living with SCD suffer from both acute and chronic complications that require close contact with the medical system. These include acute sickle cell pain, fever, and the acute chest syndrome (ACS) which is the term used for a constellation of findings that includes chest pain, cough, fever, hypoxia and new lung infiltrates. There is a significant concern that the overlap of lung disease from COVID-19 with ACS may result in increased complications and amplification of healthcare utilization among individuals with SCD. Moreover, individuals with SCD, in general, experience high utilization of acute care services including emergency departments and hospitals and often present with fever, signs and symptoms of pneumonia or evolving ACS, as well as acute sickle cell pain requiring parenteral therapy. Thus, there may be specific diagnostic, treatment and logistical challenges in meeting the healthcare needs of this population during the COVID-19 pandemic.
Here, we provide suggested guidelines for the acute and chronic disease management of patients with SCD given the multidimensional and evolving changes and challenges in our healthcare operational landscape.