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Sickle cell trait (SCT) should be considered an adverse prognostic factor for COVID-19, a genetic association study suggests.
Unlike people with sickle cell disease, who have 2 copies of hemoglobin beta sickle alleles, those with SCT have 1 hemoglobin beta sickle allele and 1 normal beta allele. The analysis found that SCT among people with African ancestry was associated with a range of preexisting kidney conditions, increased COVID-19 mortality, and increased incidence of kidney failure.
The study used data from the Million Veteran Program, a genetic biobank of US veterans, and included 2729 people with SCT and 129 848 individuals without SCT. Among those who developed COVID-19 were 353 people with SCT and 13 488 without SCT.
Almost 8% of individuals of African ancestry in the study had SCT, which was associated with a history of chronic kidney disease, diabetic kidney disease, hypertensive kidney disease, pulmonary embolism, and cerebrovascular disease. People with African ancestry who were SCT carriers had a higher risk of mortality when they developed COVID-19. In the 60 days following a COVID-19 diagnosis, individuals with SCT were more likely to develop acute kidney failure, accounting for about 21% of COVID-19 deaths among people with SCT.
According to the Centers for Disease Control and Prevention, the evidence is suggestive that people with sickle cell disease have higher risk of severe COVID-19. “Our findings support the inclusion of SCT as an adverse prognostic factor for COVID-19 and development of SCT-tailored interventions,” the investigators wrote in JAMA Internal Medicine.
Créditos: Comité científico Covid