P116: the impact of covid19 pandemic on sickle cell management: experience of a single pediatric center

Background: COVID19 pandemic has put an incomparable pressure on all health services – including those offered to hemoglobinopathy patients. Sickle cell disease management, although not routinely requiring inpatient facilities, is dependent upon hospital based services on a great extent. Aims: Aim of the present study was to evaluate the impact of COVID19 pandemic on medical management of sickle cell disease patients followed at a single pediatric center in Northern Greece. Methods: Patient records were reviewed in order to assess changes reflecting limited access to specialized care, i.e. number of disease related complications, number of hospital routine visits and number of disease related hospitalizations, during the 18month pandemic in Greece. Results: The study included 23 patients, 17 female (74%) and 6 male (26%). Age range was 2 to 19 years. Eighteen (18) patients (78.3%) were double heterozygotes for sickle cell and beta thalassemia, 4 (17.4%) were sickle cell homozygotes and 1 patient (4.3%) was double heterozygote for sickle cell disease and hemoglobinopathy D. Out of 23 patients, 4 were on regular blood transfusions due disease related issues (primary prophylaxis for cerebrovascular disease or hypersplenism in 2 cases, severe anemia or repeated pain crises in 2 other cases). No significant difference was recorded in number of hospital visits during the 18month period before and during the pandemic (5.45 visits/year and 6 visits/year, respectively – p = 0.49), reflecting a stable course for patients not receiving regular transfusions and an unaffected by blood shortage or limited hospital access course for regularly transfused patients. To that end, no significant changes were recorded in non-COVID related hospitalizations between the two groups (0.57/year before the pandemic and 0.39/year during the pandemic, p = 0.32). In addition, no difference was found between the reported number of pain crises (0.63 episodes per year vs 0.63 episodes per year, p = 1.0). An otherwise unremarkable overall clinical and laboratory course was reported for all patients during the two time periods compared. No changes in regular monitoring was noted and no changes in drug prescription or drug availability for patients on hydroxyurea was recorded. Summary-Conclusions: Although sickle cell patients require close monitoring, mostly dependent upon hospital based services, the COVID19 pandemic does not seem to have limited access to recommended care in this patient group. References 1. Orphanet J Rare Dis 2021 Mar 1;16(1):114