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Abstract
Background: Sickle
cell diseases (SCD) are severe
inflammatory processes on
vascular endothelium, particularly
at the capillaries since the
capillary system is the main
distributor of hardened red
blood cells into the tissues.
Similarly, coronavirus disease
(COVID-19) may also be a genetically
determined inflammatory process
particularly in pulmonary
capillaries with much higher
mortality rates in some families.
Methods:
All patients with the SCD
were studied.
Results:
The study included 222 males
and 212 females with similar
mean ages (30.8 versus 30.3
years, p>0.05, respectively).
Smoking (23.8% versus 6.1%,
p<0.001), alcohol (4.9%
versus 0.4%, p<0.001),
disseminated teeth losses
(5.4% versus 1.4%, p<0.001),
ileus (7.2% versus 1.4%, p<0.001),
cirrhosis (8.1% versus 1.8%,
p<0.001), leg ulcers (19.8%
versus 7.0%, p<0.001),
digital clubbing (14.8% versus
6.6%, p<0.001), coronary
heart disease (CHD) (18.0%
versus 13.2%, p<0.05),
chronic renal disease (CRD)
(9.9% versus 6.1%, p<0.05),
chronic obstructive pulmonary
disease (COPD) (25.2% versus
7.0%, p<0.001), and stroke
(12.1% versus 7.5%, p<0.05)
were all higher but not acute
chest syndrome (ACS), in males
(2.7% versus 3.7%, p>0.05).
Conclusion:
Although smoking, alcohol,
disseminated teeth losses,
ileus, cirrhosis, leg ulcers,
digital clubbing, CHD, CRD,
COPD, and stroke-like atherosclerotic
end-points were all higher
in males, prevalence of ACS
was similar in both genders.
In another definition, ACS
and severe COVID-19 may be
genetically determined exaggerated
immune response syndromes
particularly in pulmonary
capillaries, and immunomodulatory
drugs including dexamethasone
probably should take the major
role in the treatment.
Key
words: Acute chest syndrome,
coronavirus disease, exaggerated
immune response syndromes,
sickle cell diseases, capillary
endothelial inflammation,
capillary endothelial edema,
tissue hypoxia
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