Sickle cell disease ups risk of COVID-19: Understand the triggers, minimise the threat

Sickle cell disease (SCD) is a genetically inherited condition that affects millions of people worldwide. Living with this condition in the times of COVID-19 is not easy and extra precautions are a must. People with sickle cell disease are more vulnerable to COVID-19 because they are immunocompromised. They must be cautious during the pandemic and ensure they follow protocols including masking, social distancing, handwashing, etc. A bit of caution, awareness and daily management can help avert the risk.

What is sickle cell disease?

In sickle cell disease, the normally flexible red blood cells (RBCs) become stiff and sticky and acquire a sickle or crescent shape. The sickle-shaped RBCs cluster together and attach to the walls of blood vessels. This further cuts off the blood supply and oxygen to different body parts or organs leading to organ damage or even stroke. The disease is caused by the mutation of a gene that controls RBC production. Sickle cells carry a type of haemoglobin that contributes to the characteristic sickling. While a person with a single sickle cell gene may be an asymptomatic carrier, SCD appears in those who inherit two sickle cell genes, one from each ‘carrier’ parent. Some complications in a person with SCD include anaemia, pain, slow growth, vision problems, low immunity, recurrent venous thromboembolism, etc. Some other complications that may require treatment include leg ulcers, gallstones, and stroke.

Understanding the triggers

There are certain conditions that can trigger or exacerbate the pain associated with SCD. This includes extreme temperatures, lack of oxygen in high altitudes, etc. People with this condition must avoid the consumption of alcohol and smoking. This is because both these habits can cause dehydration and trigger a lung condition called acute chest syndrome. Even common illnesses can be harmful to such patients. There is a need to understand that pressure or stress of any nature must be avoided. In the absence of such triggers, the condition can be kept stable.

Pain management

Managing pain is a very important aspect of SCD. Patients with the condition must keep in touch with their doctor regularly and find out how they can relieve their pain. This could be through medication or other therapies. There may be certain things that can trigger pain and should be avoided. As with any other condition, there is no one-size-fits-all even in SCD. Find out what works best for you and manage your condition accordingly in consultation with your doctor.

Role of caregivers

Caregivers have an integral role in helping patients with SCD. They can help understand crises situations, become the much-needed support system for the family, and be alert to triggers. They can also help with pain management through various techniques and reach out to the medical professionals in case the situation goes out of hand. They are also an essential cog in helping families deal with the diagnosis. While SCD can impact a person’s physical and mental health (given the stigma surrounding the condition), an at-home management and support system can be beneficial. There are various home healthcare companies that can help with medical assistance and medication schedules. This is especially important given the fact that people with SCD are prone to infections such as the COVID-19. The pain that accompanies SCD is different in each person. Understanding how it can be managed in consultation with a specialist is necessary as much as talking about your feelings with a caregiver or anyone you are close to.

Managing the symptoms

While it is a chronic condition, it is possible for people to live a full life and carry on with most of their daily activities with proper management. Most of the treatment methodologies for this condition are aimed at alleviating pain and other side effects symptomatically. Just as with any other condition, there are few things that people with SCD must keep in mind to prevent the symptoms from becoming worse.

• Strive to maintain a healthy lifestyle that includes a good and nourishing diet plan, proper sleep, adequate hydration, and regular physical activity. However, one should not undertake any strenuous activities.
• Avoid smoking and try to quit if you have a habit. Drink alcohol in moderation.
• Avoid situations that may set off a crisis such as exposure to extreme temperatures. It is best to not exert too much and get good rest.
• Do not travel in an aircraft cabin that is unpressurized.
• Make sure you adhere to the medication schedule. Get any medical and lab tests or immunizations that your doctor orders.
• Visit your doctor immediately in case of the signs such as fever, breathing issues, splenic enlargement, sudden vision loss and severe anaemia.

In conclusion

SCD is a complex disease and in some cases, the disease may not produce any symptoms at all until after many years. Patients with SCD require more than the normal intake of proteins and other nutrients. Along with innovative medical pathways, wholesome nutrition is a key factor in the holistic management of SCD. This and adequate at-home care can provide a better quality of life for patients.