key: cord-0877271-9hd54ug5
authors: Al‐Hebshi, Abdulqader; Zolaly, Mohammed; Alshengeti, Amer; Al Qurainees, Ghaya; Yamani, Sofyan; Hamdan, Naif; Alwasaidi, Turki
title: A Saudi family with sickle cell disease presented with acute crises and COVID‐19 infection
date: 2020-07-10
journal: Pediatr Blood Cancer
DOI: 10.1002/pbc.28547
sha: 1152188b2437d3ecbe994667946a1b6ea75e6a88
doc_id: 877271
cord_uid: 9hd54ug5

nan

Evidence about COVID-19 in children is evolving, but many questions are still unanswered. In systematic reviews, children represent 1% to 5% of all confirmed cases, often occurring in family clusters. 2 Sickle cell anemia (SCA) patients are immunocompromised mainly because of the loss of splenic functions. 3 Viral infections are triggers of vaso-occlusive crises (VOC) and acute chest syndrome (ACS). 4, 5 At present, COVID-19 presentation and outcomes in SCA have not been reported in the Kingdom of Saudi Arabia (KSA). We are reporting three cases of SCA with COVID-19 in a mother and two of her children. On physical examination, she was in moderate to severe pain without respiratory distress, oxygen saturation 99% at room air, heart rate 95/minute, temperature 38.5 • C, respiratory rate 20 breath/minute, and blood pressure 121/61 mmHg. A systemic examination showed generalized mild tenderness in both thighs and arms, and she was otherwise normal.

Her complete blood count was normal except anemia (hemoglobin) 88 g/L and leukocytosis (white blood cells 16.2 × 10 9 /L). C-reactive protein (CRP) was normal at 3. His complete blood count was normal except anemia (hemoglobin 8.8 g/dL) and leukocytosis (white blood cells 23.4 × 10 9 /L). CRP was 17.7 mg/L. The chest X-ray was normal initially.

He was admitted as having VOC with suspected COVID-19. On day 2 of admission, he developed fever (39.3 • C) with hypoxia; SpO 2 was 88% on room air. A repeat chest X-ray showed new infiltration with a suspicion of ground glass opacities (Figure 1 ). Ceftriaxone and azithromycin were administered due to suspected ACS, with oxygen 2 L/min by nasal cannula. The inflammatory markers were worsening (Supporting Information Table S1 ). SARS-CoV-2 RT-PCR was positive, and a respiratory virus multiplex PCR was negative for other viruses. Antibiotics were upgraded to meropenem and

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