Document Type
Article
Publication Date
11-26-2024
Abstract
BACKGROUND: Dexamethasone is a steroid used in the treatment of hospitalized patients with severe COVID-19. However, the effect of dexamethasone in patients with SCD remains unclear given that steroids may precipitate vaso-occlusive crisis (VOC) in patients with SCD.
METHODS AND FINDINGS: We performed a retrospective analysis of patients with SCD who were hospitalized at Johns Hopkins Health System between June 1, 2020 and June 26, 2022. We reviewed individual charts to assess severity of illness and eligibility for dexamethasone treatment. The exposure of interest was treatment with dexamethasone. Outcomes of interest included incident VTE, length of hospital stay, ICU admission, follow up-VOC and mortality. We identified 30 patients with SCD and COVID-19 who were eligible for dexamethasone treatment, 13 of whom received dexamethasone. Dexamethasone was associated with an increased risk of incident VTE (risk difference = 36%; 95% CI 8%, 66%) after adjustment for high-risk genotypes, >3 hospitalizations, and receipt of anticoagulation. There was an increase in the risk difference of ICU admission and an increased length of stay in crude and adjusted analyses however these associations were not statistically significant.
CONCLUSIONS: We analyzed outcomes among patients with SCD who were hospitalized for COVID-19 and eligible for dexamethasone. Our study suggests that in this population, treatment with dexamethasone increases the risk of incident VTE. There was a suggestion of an increased risk of ICU admission as well as increased length of hospitalization; larger studies are needed to confirm these findings.
Recommended Citation
Garneau, William M.; Lankiewicz, Matthew J.; Lesko, Catherine R.; Lauriello, Ashley P.; Gebo, Kelly A.; and Lanzkron, Sophie M., "Clinical Effects of Dexamethasone Among Patients With Sickle Cell Disease Hospitalized With COVID-19: Outcomes From a Single Academic Health System" (2024). Department of Medicine Faculty Papers. Paper 475.
https://jdc.jefferson.edu/medfp/475
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
39591463
Language
English
Comments
This article is the author's final published version in PLoS ONE, Volume 19, Issue 11, November 2024, Article number e0313289.
The published version is available at https://doi.org/10.1371/journal.pone.0313289.
Copyright © 2024 Garneau et al