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β-地中海贫血患者的 SARS-CoV-2 感染:法国的经验。

SARS-CoV-2 infection in patients with β-thalassemia: The French experience.

机构信息

Département de médecine interne, hôpital de la Timone, Assistance Publique des hôpitaux de Marseille, Marseille, France; Centre de référence des syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'erythropoïèse, Assistance Publique des hôpitaux de Marseille, 264, rue Saint-Pierre, 13005 Marseille, France.

Service de médecine interne, centre de référence des syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'Erythropoïèse, hôpital Henri Mondor, APHP, Paris, France.

出版信息

Transfus Clin Biol. 2022 Feb;29(1):70-74. doi: 10.1016/j.tracli.2021.06.007. Epub 2021 Jul 1.

Abstract

INTRODUCTION

Because of iron overload complications, thrombosis and infectious predisposition, patients with severe forms of thalassemia are likely to be at increased risk of COVID-19 complications.

RESULTS

A national survey conducted during the year 2020 across the French reference centers for hemoglobinopathies identified 16 cases of COVID-19 confirmed by RT-PCR in beta-thalassemia patients. Their age ranged from 11 months to 60 years. 15 patients were transfusion-dependent and 6 were splenectomized. Concerning iron overload related complications, none had diabetes or cirrhosis and only one had experienced heart failure. All 4 pediatric patients were pauci-symptomatic during the viral episode. Three patients (41, 49 and 57 years old) developed COVID-19 pneumonia requiring oxygen therapy without the need for mechanical ventilation. Neutropenia (absolute neutrophils count <0.5 10 /L) was observed in 2 patients receiving long-term treatment with hydroxycarbamide and deferiprone. No thrombosis event, organ failure or death occurred. All patients recovered.

CONCLUSION

Severity of COVID-19 in this population of young and middle-aged patients appeared increased compared to the general population but remained mild to moderate as already described in the few series reported in the literature. Occurrence of adverse events related to chronic treatment administered in thalassemia disease may be favored by the infectious episode.

摘要

简介

由于铁过载并发症、血栓形成和易感染倾向,严重型地中海贫血患者可能面临更高的 COVID-19 并发症风险。

结果

2020 年,法国血红蛋白病参考中心开展了一项全国性调查,共发现 16 例经 RT-PCR 确诊的β-地中海贫血患者 COVID-19 病例。他们的年龄从 11 个月到 60 岁不等。15 名患者依赖输血,6 名患者接受了脾切除术。关于铁过载相关并发症,无糖尿病或肝硬化,仅 1 例发生心力衰竭。4 名儿科患者在病毒发作期间仅有轻微症状。3 名患者(41、49 和 57 岁)发生 COVID-19 肺炎,需要吸氧治疗,但无需机械通气。2 名长期接受羟基脲和去铁酮治疗的患者出现中性粒细胞减少症(绝对中性粒细胞计数 <0.5 10 /L)。无血栓事件、器官衰竭或死亡发生。所有患者均康复。

结论

与普通人群相比,该人群中青年患者 COVID-19 的严重程度似乎更高,但与文献中报道的少数几例病例一样,仍为轻度至中度。与地中海贫血疾病中给予的慢性治疗相关的不良事件的发生可能因感染而加重。

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本文引用的文献

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β-Thalassemias.β地中海贫血
N Engl J Med. 2021 Feb 25;384(8):727-743. doi: 10.1056/NEJMra2021838.

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