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Comparison of in-hospital mortality in children and adolescents with sickle cell disease in a resource-limited setting before and during the COVID-19 pandemic - 03/01/24

Doi : 10.1016/j.arcped.2023.10.001 
Eposse Ekoube Charlotte a, b, Mandeng Ma Linwa Edgar b, c, , Puepi Djike Yolande c, Kedy Mangamba Koum Daniele-Christiane a, Mbono Ritha Betoko a, b, Epee Patricia a, Hassanatou Iyawa a, b, Michael Budzi Ngenge c, Megoze Abigaelle d, Noukeu Njinkui Diomède e, Enyama Dominique e, Ntsoli Kofane Gaelle b, Jackson Juliana b, Ekotto Karen b, Mony Elimbi Jeanne Georgette b, Etame Moussinga Margaret b, Ekoe Doriane b, Calixte Ida Penda a
a Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon 
b Laquintinie Hospital of Douala, Douala, Cameroon 
c Faculty of Health Sciences, University of Buea, Buea, Cameroon 
d Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon 
e Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon 

Corresponding author.

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Abstract

Background

COVID-19 in children and adolescents with sickle cell disease (SCD) has variable presentations (from mild to severe disease), and the main symptoms are vaso-occlusive crises (VOC) and acute chest syndrome (ACS). We hypothesized that the desertion of hospitals due to the pandemic would lead to late arrival at the emergency room and an increased mortality. In this study, we sought to measure and compare the mortality of children with sickle cell disease before and during the COVID-19 pandemic.

Material and methods

We conducted a retrospective cohort study at the sickle cell disease management center of Laquintinie Hospital in Douala (Cameroon). The study period was divided into two, i.e., from March 2019 to February 2020 (Pre-COVID-19) and from March 2020 to February 2021 (COVID-19). All administrative and ethical considerations were fully respected. Data were analyzed using SPSS 20.0.

Results

Overall, 823 patients were admitted during the study period. Males represented 52.4% of the overall population, giving a sex ratio of 1.1:1. We admitted 479 patients during the pre-COVID-19 period versus 344 patients during the COVID-19 period, which is a 28.2% drop in admissions during the COVID-19 period. The mortality rate was 3.5% during the pre-COVID-19 period and 3.2% during the COVID-19 period (p>0.05). The most common causes of death were ACS (39.3%, n = 11), severe anemia (25.0%, n = 7), and VOC (17.9%, n = 5). ACS (adjusted odds ratio [aOR]=3.628, 95% confidence interval [CI], [1.645–7.005], p<0.001) was significantly associated with mortality.

Conclusion

During the COVID-19 pandemic, although the consultation frequency decreased, the mortality rate of sickle cell disease patients remained unchanged.

El texto completo de este artículo está disponible en PDF.

Keywords : COVID-19, Sickle cell disease, Mortality, Cameroon


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© 2023  French Society of Pediatrics. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 31 - N° 1

P. 38-43 - janvier 2024 Regresar al número
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